Nouri-Merchaoui S, Mahdhaoui N, Trabelsi S, Seboui H
Service de néonatologie, CHU Farhat Hached, Sousse, Tunisia.
Arch Pediatr. 2012 Apr;19(4):413-8. doi: 10.1016/j.arcped.2012.01.006. Epub 2012 Feb 29.
Arterial thromboses are rare in newborns, mostly caused by arterial catheters. Neonatal arterial thrombosis occurring in other contexts is much rare. We report arterial thrombosis, not caused by catheterisation in 4 neonates hospitalised in the neonatology department of the Farhat Hached de Sousse hospital in Tunisia. The diagnosis of arterial thrombosis was made based on signs of ischemia in 2 patients affected by thrombosis of the iliac arteries. The symptoms were less clear: anuria associated with arterial high blood pressure in 1 patient affected by thrombosis of the abdominal aorta and by anuria with melena in a newborn with aortic and mesenteric thrombosis. Diagnosis was confirmed by Doppler sonography in 3 patients and based on autopsy data in 1 patient. A delay to consultation was noted in 3 patients, whose outcome was fatal. The progression was favourable after thrombolysis and anticoagulation using heparin in 1 patient with major aortic thrombosis. A review of the literature on the epidemiological, clinical, therapeutic and outcome data of the arterial thrombosis in the newborn child is provided.
动脉血栓在新生儿中较为罕见,主要由动脉导管引起。在其他情况下发生的新生儿动脉血栓则更为罕见。我们报告了突尼斯苏塞法哈特·哈谢德医院新生儿科收治的4例非因导管插入术导致的动脉血栓病例。2例髂动脉血栓形成的患儿根据缺血体征诊断为动脉血栓。症状不太明显:1例腹主动脉血栓形成的患儿出现无尿伴动脉高血压,1例主动脉和肠系膜血栓形成的新生儿出现无尿伴黑便。3例患儿通过多普勒超声确诊,1例根据尸检数据确诊。3例患儿就诊延迟,预后不良。1例主动脉大血栓形成的患儿经肝素溶栓和抗凝治疗后病情进展良好。本文还对新生儿动脉血栓的流行病学、临床、治疗及预后数据的相关文献进行了综述。