Bambuch Miroslav, Latta Jiří
Vnitr Lek. 2014 Feb;60(2):171-6.
Catheter related septic central venous thrombosis (CR-SCVT) is an uncommon but serious complication related to central venous catheter use. Prolonged sepsis, late detection of the right diagnosis, difficult, long and costly treatment (and its own complications) threaten patients with further, potentially lethal complications. By the patients with an evidence of catheter sepsis, which persists despite targeted antibiotic therapy, it is important to think of this possible complication. Diagnosis can be determined by a combination of clinical, laboratory, microbiological and imaging techniques, from which is transesophageal echocardiography the most useful diagnostic test. Treatment of CR-SCVT consists of long-term targeted antibiotic therapy, the role of anticoagulation is not clearly solved. The article presents case studies of four patients diagnosed and treated in our clinic for infected thrombus in the superior vena cava and right atrium in relation with a central venous catheter. It also compares our diagnostic and therapeutic strategies with the similar cases described in literature.
导管相关脓毒性中心静脉血栓形成(CR-SCVT)是一种与中心静脉导管使用相关的罕见但严重的并发症。长期败血症、正确诊断的延迟发现、困难、漫长且昂贵的治疗(及其自身并发症)会使患者面临进一步的、潜在致命并发症的威胁。对于尽管接受了针对性抗生素治疗但仍存在导管败血症证据的患者,考虑这种可能的并发症很重要。诊断可通过临床、实验室、微生物学和影像学技术相结合来确定,其中经食管超声心动图是最有用的诊断测试。CR-SCVT的治疗包括长期针对性抗生素治疗,抗凝的作用尚未明确解决。本文介绍了在我们诊所诊断和治疗的4例与中心静脉导管相关的上腔静脉和右心房感染性血栓患者的病例研究。还将我们的诊断和治疗策略与文献中描述的类似病例进行了比较。