Spatenka J, Smelhaus V, Spicáková V, Janda J, Cerný K, Starý J, Lochman O, Honĕk T
Kardiocentrum fakultní nemocnice v Motole, Praha.
Cesk Pediatr. 1990 Aug;45(8):449-55.
The authors explain the principle of central venous catheters (CVC) for long-term use, indicators for insertion, mode of insertion and principles of care of children with these special CVC. The authors inserted since 1982 42 CVC of the Broviac-Hickmann type in 32 children (age 22 days--15 years; body weight 2.4-17 kg). Since 1987 they inserted 16 CVC for long-term use with a subcutaneous capsule to 16 children and adolescents (age 1 years-17 years; body weight 11.5-73.5 kg). These CVC were inserted under general anaesthesia, in catheterization theatre. There were no technical complications. The authors treated and followed under standard protocol a group of 14 children with 20 CVC of the Broviac type (age at onset of treatment 22-715 days; body weight 2.4-10 kg) as well as the above described group of 16 children and adolescents with CVC for long-term use with a subcutaneous capsule. During treatment of children with Broviac catheters five technical complications were observed (mechanical damage of the CVC); in children with CVC with a subcutaneous capsule one technical complication was recorded (damage of the chamber of the Chemoport Vygon system, by incorrect puncture). The authors searched for thromboembolic and infectious complications. In four of 20 children with Broviac catheters purulent phlebitis of the cannulated veins was found (all died)--one thromboembolic complication developed on average after 234 days of use of Broviac catheters.(ABSTRACT TRUNCATED AT 250 WORDS)
作者阐述了长期使用的中心静脉导管(CVC)的原理、置入指征、置入方式以及使用这些特殊CVC的儿童的护理原则。自1982年以来,作者为32名儿童(年龄22天至15岁;体重2.4至17千克)置入了42根Broviac - Hickmann型CVC。自1987年起,他们为16名儿童和青少年(年龄1岁至17岁;体重11.5至73.5千克)置入了16根带皮下囊的长期使用CVC。这些CVC在全身麻醉下于导管插入术手术室置入。无技术并发症。作者按照标准方案对一组14名使用20根Broviac型CVC的儿童(治疗开始时年龄22至715天;体重2.4至10千克)以及上述16名使用带皮下囊长期使用CVC的儿童和青少年进行治疗和随访。在使用Broviac导管的儿童治疗期间,观察到5例技术并发症(CVC机械损伤);在使用带皮下囊CVC的儿童中,记录到1例技术并发症(因穿刺不当导致Chemoport Vygon系统腔室损坏)。作者查找血栓栓塞和感染并发症。在20名使用Broviac导管的儿童中,发现4例置管静脉脓性静脉炎(均死亡),平均在使用Broviac导管234天后发生1例血栓栓塞并发症。(摘要截于250字)