Belcastro S, Susa A, Pavanelli L, Guberti A, Buccoliero C
Department of Surgery, University of Ferrara, Italy.
JPEN J Parenter Enteral Nutr. 1990 Jan-Feb;14(1):31-3. doi: 10.1177/014860719001400131.
Total parenteral nutrition (TPN) today is a fundamental procedure in the treatment of critically ill patients, especially if they have serious gastrointestinal diseases. However, use of the central venous catheter is connected with a very important morbidity. At the "Istituto di Patologia Chirurgica" and at the "Intensive Care Unit" of the University of Ferrara, we analyzed 59 cases of deaths from different diseases, on whom a postmortem examination had been performed. Twenty-seven patients had had no central venous catheter: none of them presented thrombosis of the central veins. Thirty-two patients had had a central venous catheter for TPN: five of them presented thrombosis of the central veins at the post-mortem examination. Except for one case who had thrombosis connected with a carcinoma of the right main bronchus, four cases (12.9%) presented thrombosis due to the central venous catheter. The subclavian vein seems to be more commonly connected with thrombosis than the jugular vein.
如今，全胃肠外营养（TPN）是治疗重症患者的一项基本措施，尤其是对于患有严重胃肠道疾病的患者。然而，中心静脉导管的使用伴随着非常重要的发病风险。在费拉拉大学的“外科病理学研究所”和“重症监护病房”，我们分析了59例因不同疾病死亡且已进行尸检的病例。27例患者未使用中心静脉导管：他们均未出现中心静脉血栓形成。32例患者因TPN使用了中心静脉导管：其中5例在尸检时出现中心静脉血栓形成。除1例血栓形成与右主支气管癌有关外，4例（12.9%）因中心静脉导管出现血栓形成。锁骨下静脉似乎比颈静脉更易发生血栓形成。
