Conlan M G, Haire W D, Lieberman R P, Lund G, Kessinger A, Armitage J O
Department of Internal Medicine, University of Nebraska, Medical Center, Omaha.
Bone Marrow Transplant. 1991 Mar;7(3):235-40.
Long-term indwelling central venous catheters have eased the administration of drugs, blood products, and hyperalimentation to patients with cancer. However, their use is associated with thrombotic complications. We report here on the thrombotic complications prospectively observed in 46 patients with refractory lymphoma (22 Hodgkin's disease, 24 non-Hodgkin's lymphoma) who had placement of one or more catheters in preparation for autologous stem cell transplantation (ASCT). Thrombosis of 26 catheters in 19 patients was observed. Specific abnormalities of hemostasis were equally common in patients who developed thrombosis and in those who did not. Thrombotic complications were more common in patients with Hodgkin's disease (13/22) than in patients with non-Hodgkin's lymphoma (6/24, p = 0.04). Although more patients with Hodgkin's disease had received prior splenectomy and/or irradiation to the area involved by thrombosis than patients with non-Hodgkin's lymphoma, the incidence of splenectomy and irradiation was similar for patients with Hodgkin's disease who developed thrombosis and those who did not. Therefore, although the etiology remains unexplained, patients with Hodgkin's disease undergoing intensive chemotherapy and ASCT appear to have a higher incidence of catheter-related thrombosis than patients with non-Hodgkin's lymphoma undergoing similar therapy.
长期留置中心静脉导管减轻了对癌症患者进行药物、血液制品和胃肠外营养给药的难度。然而，其使用与血栓形成并发症相关。我们在此报告了46例难治性淋巴瘤患者（22例霍奇金病，24例非霍奇金淋巴瘤）在准备自体干细胞移植（ASCT）时放置了一根或多根导管后前瞻性观察到的血栓形成并发症。观察到19例患者的26根导管发生血栓形成。发生血栓形成的患者和未发生血栓形成的患者中，止血的特定异常情况同样常见。霍奇金病患者（13/22）的血栓形成并发症比非霍奇金淋巴瘤患者（6/24，p = 0.04）更常见。尽管与非霍奇金淋巴瘤患者相比，更多霍奇金病患者曾接受过脾切除术和/或血栓形成累及部位的放疗，但发生血栓形成的霍奇金病患者和未发生血栓形成的患者的脾切除术和放疗发生率相似。因此，尽管病因仍不明，但接受强化化疗和ASCT的霍奇金病患者似乎比接受类似治疗的非霍奇金淋巴瘤患者发生导管相关血栓形成的发生率更高。
