Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Lyon, France; University of Lyon Claude Bernard, Lyon, France.
Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Lyon, France.
J Pediatr. 2018 Jul;198:46-52. doi: 10.1016/j.jpeds.2018.03.026. Epub 2018 Apr 27.
To study the risk of catheter-associated thrombosis (CAT) between peripherally inserted central catheters (PICCs) and tunneled central venous catheters in children with leukemia.
We analyzed all PICCs and conventional tunneled catheters placed in patients aged <18 years and admitted to our institute for leukemia treatment between February 2008 and April 2014. Cases of symptomatic CAT were confirmed by ultrasound and treated with low-molecular-weight heparin.
During the study period, 157 PICCs and 138 conventional tunneled catheters were placed in 192 patients with leukemia. CAT incidence was 1.5% (n = 2) in the conventional tunneled catheter group and 10.2% (n = 16) in the PICC group. The OR for CAT occurrence after PICC vs conventional tunneled catheter placement was 5.6 (95% CI, 1.2-26.5).
Our results suggest that the use of PICCs in children with leukemia increases the risk of CAT in comparison with the use of conventional tunneled catheters. Further randomized controlled studies are needed to characterize this risk and to better define indications.
研究白血病患儿中经外周静脉穿刺中心静脉置管（PICC）与隧道式中心静脉置管（TCC）发生导管相关性血栓（CAT）的风险。
我们分析了 2008 年 2 月至 2014 年 4 月期间在我院因白血病接受治疗的年龄<18 岁的所有患者中置入的 PICC 和传统 TCC。通过超声检查确认有症状的 CAT 病例，并采用低分子肝素进行治疗。
在研究期间，192 例白血病患者中置入了 157 根 PICC 和 138 根传统 TCC。传统 TCC 组的 CAT 发生率为 1.5%（n=2），PICC 组为 10.2%（n=16）。与传统 TCC 相比，PICC 后发生 CAT 的 OR 为 5.6（95%CI，1.2-26.5）。
与传统 TCC 相比，白血病患儿使用 PICC 会增加 CAT 的发生风险。需要进一步开展随机对照研究以明确这种风险，并更好地定义适应证。
