1Division of Pediatric Hematology, Department of Pediatrics, Medical Faculty of Uludag, Nilüfer, Bursa, Turkey.
Clin Appl Thromb Hemost. 2013 Sep;19(5):574-7. doi: 10.1177/1076029612441053. Epub 2012 Apr 11.
The information about the thromboembolic events, the optimal treatment choice, the dose, and duration of antithrombotic therapy in children are limited. More clinical data are required. Recombinant tissue plasminogen activator (r-tPA) is increasingly used in pediatric thrombosis. We retrospectively analyzed the clinical course of 7 children (9.3 ± 2.1 years; 34 days to 16 years) with arterial thrombosis (n = 1) and intracardiac thrombosis (n = 6). The children were treated with r-tPA. The dose ranged between 0.2 and 0.4 mg/kg per h infused for 3 to 4 hours. This dose was repeated between 2 to 7 times till the thrombolysis was achieved. Treatment side effects were closely monitored. Complete clot lysis was achieved in all cases. None of them had severe bleeding except mild recurrent epistaxis occurring in 2 cases. In conclusion, r-tPA is an effective and safe therapy under close hemostatic control in children.
血栓栓塞事件、最佳治疗选择、抗血栓治疗的剂量和持续时间在儿童中均有限。需要更多的临床数据。重组组织型纤溶酶原激活物（r-tPA）在儿科血栓形成中的应用越来越多。我们回顾性分析了 7 例（9.3±2.1 岁；34 天至 16 岁）动脉血栓形成（n=1）和心内血栓形成（n=6）患儿的临床病程。患儿接受 r-tPA 治疗。剂量为 0.2 至 0.4mg/kg/h，输注 3 至 4 小时。该剂量重复 2 至 7 次，直至溶栓成功。密切监测治疗的副作用。所有病例均完全溶解血栓。除 2 例出现轻度复发性鼻出血外，无严重出血。总之，r-tPA 在密切止血控制下是一种有效且安全的治疗方法。
