[尿激酶在处理经外周静脉穿刺中心静脉置管堵塞中的应用]
[Urokinase in the management of occluded PICC lines].
作者信息
Muller C, Jacquier A, Varoquaux A, Cohen F, Louis G, Gaubert J Y, Moulin G, Bartoli J M, Vidal V
机构信息
Service de Radiologie, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05.
出版信息
J Radiol. 2010 Mar;91(3 Pt 1):287-91. doi: 10.1016/s0221-0363(10)70040-8.
PURPOSE
To determine the efficacy and safety of urokinase in the management of occluded PICC lines.
MATERIALS AND METHODS
A total of 587 PICC lines were placed over an 11 month period. During this period, 28 PICC lines (4.8%) became occluded: 12 occluded PICC lines were successfully managed by simple flushing with normal saline while 16 PICC lines were thrombolyzed with urokinase.
RESULTS
After urokinase, 93.8% (15/16) of occluded PICC lines were completely patent. A single infusion of urokinase, 20,000 IU over 30 minutes, was used in all cases. No secondary occlusion or complication was noted after urokinase.
CONCLUSION
Urokinase is effective and safe to restore patency to occluded PICC lines. The procedure is simple, and could be performed at the bedside by nursing staff after medical prescription. It is an alternative to over the wire PICC line exchange, that could reduce the risk of complication related to manipulations, patient discomfort and cost.
目的
确定尿激酶在处理经外周静脉穿刺中心静脉置管（PICC）堵塞中的有效性和安全性。
材料与方法
在11个月的时间里共置入587根PICC导管。在此期间，28根PICC导管（4.8%）发生堵塞：12根堵塞的PICC导管通过用生理盐水简单冲洗成功处理，而16根PICC导管用尿激酶进行了溶栓治疗。
结果
使用尿激酶后，93.8%（15/16）的堵塞PICC导管完全通畅。所有病例均单次输注尿激酶20000国际单位，持续30分钟。使用尿激酶后未发现二次堵塞或并发症。
结论
尿激酶在恢复堵塞的PICC导管通畅方面有效且安全。该操作简单，可在医嘱下达后由护理人员在床边进行。它是钢丝引导下更换PICC导管的一种替代方法，可降低与操作相关的并发症风险、患者不适及费用。
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