Lambert D, Martin C, Perrin G, Saux P, Papazian L, Gouin F
Département d'Anesthésie-Réanimation, Hôpital Sainte-Marguerite, Marseille.
Ann Fr Anesth Reanim. 1990;9(5):408-11. doi: 10.1016/s0750-7658(05)80946-3.
The thrombosis rate after long-term cannulation of the radial artery was assessed prospectively in 48 intensive care patients randomly assigned to groupe A (polyethylene Leader-Cath 115-09 catheter; n = 50, aged 55 +/- 20 years, 74% male patients) or groupe B (Teflon Viggo Floswitch 4441 catheter; n = 48, aged 58.6 +/- 16 years, 73% male patients). Bedside angiography was carried out with 10 to 15 ml Hexabrix before removal of the catheter. The two groups were similar with regard to anthropometric parameters, used drugs, pathological events during the stay in ICU, arterial cannulation technique and its duration. There was no case of clinically significant ischaemia. The rate of X-ray total arterial thrombosis was 20% in group A, and 2% in group B (p less than 0.01). There was no difference in the rate of partial thrombosis (54% vs. 41.7% respectively, NS) and of lack of thrombosis (26% vs. 56.3% respectively, NS). The overall rate of thrombosis was greater in group A than in group B, but not significantly (74% vs. 43.7% respectively). The duration of arterial cannulation did not influence the rate of thrombosis. However it was higher in males of Group A than in those of Group B (p less than 0.01), when heparin was not given (p less than 0.05); when vaso-active drugs were used (p less than 0.05); and when the time required for cannula insertion was greater than 5 min (p less than 0.01). It is concluded that Teflon catheters are more biocompatible than polyethylene catheters.
对48例重症监护患者进行前瞻性评估，这些患者被随机分为A组（使用聚乙烯Leader - Cath 115 - 09导管；n = 50，年龄55±20岁，男性患者占74%）或B组（使用聚四氟乙烯Viggo Floswitch 4441导管；n = 48，年龄58.6±16岁，男性患者占73%），评估桡动脉长期置管后的血栓形成率。在拔除导管前，使用10至15毫升碘克沙醇进行床旁血管造影。两组在人体测量参数、使用的药物、在重症监护病房住院期间的病理事件、动脉置管技术及其持续时间方面相似。没有发生具有临床意义的缺血病例。A组X线显示的总动脉血栓形成率为20%，B组为2%（p＜0.01）。部分血栓形成率（分别为54%和41.7%，无统计学差异）和无血栓形成率（分别为26%和56.3%，无统计学差异）没有差异。A组的总体血栓形成率高于B组，但差异不显著（分别为74%和43.7%）。动脉置管持续时间不影响血栓形成率。然而，在未使用肝素时（p＜0.05）、使用血管活性药物时（p＜0.05）以及置管所需时间大于5分钟时（p＜0.01），A组男性的血栓形成率高于B组男性。结论是聚四氟乙烯导管比聚乙烯导管具有更好的生物相容性。
