Mourot Joshua M, Oliveira Hermes M, Woodson Lee C, Herndon David N, Chung Dai H
Department of Surgery, The University of Texas Medical Branch and Shriners Burns Hospital for Children, Galveston, Texas, USA.
J Burn Care Res. 2009 May-Jun;30(3):432-6. doi: 10.1097/BCR.0b013e3181a28c6e.
A retrospective analysis of all pediatric patients admitted for acute burn treatment during a 7-year period was conducted to examine patients who underwent femoral artery catheterization and discuss the associated complications and treatment options. The total number of femoral artery catheterizations performed, nature of vascular complications, treatment rendered, and patient outcome were reviewed. Of the 1800 acute burn pediatric patients treated during our study period (1996-2002), 234 patients underwent a total of 745 femoral artery catheterizations. There was a 1.9% incidence of significant complications as a result of catheterization, including problems during catheter insertion, diminished distal arterial pulses following catheter placement and catheter malfunction. Eight patients (3.4%) developed occlusion or spasm of the femoral artery evidenced by loss of distal pulses. Of these, three required thrombectomy and the other five were treated nonsurgically with immediate catheter removal and systemic heparinization. Both groups showed similar overall outcome with return of distal pulses and absence of distal limb or tissue loss. Our findings indicate that femoral artery catheterization in pediatric burn patients is associated with a low occurrence of vascular complications. The majority of patients with acute distal limb ischemic symptoms can be managed nonoperatively with immediate removal of the catheter and systemic heparinization.
对7年间收治的所有接受急性烧伤治疗的儿科患者进行了回顾性分析，以检查接受股动脉插管的患者，并讨论相关并发症及治疗选择。回顾了股动脉插管的总次数、血管并发症的性质、所采取的治疗措施以及患者的预后情况。在我们的研究期间（1996 - 2002年）治疗的1800例急性烧伤儿科患者中，234例患者共接受了745次股动脉插管。插管导致的严重并发症发生率为1.9%，包括插管过程中的问题、插管后置管远端动脉搏动减弱以及导管故障。8例患者（3.4%）出现股动脉闭塞或痉挛，表现为远端脉搏消失。其中，3例需要进行血栓切除术，另外5例采用非手术治疗，即立即拔除导管并进行全身肝素化治疗。两组患者的总体预后相似，远端脉搏恢复，未出现远端肢体或组织丧失。我们的研究结果表明，儿科烧伤患者股动脉插管的血管并发症发生率较低。大多数出现急性远端肢体缺血症状的患者可通过立即拔除导管并进行全身肝素化治疗进行非手术处理。
