Faculty of Medicine, Ataturk University, Erzurum, Turkey.
Erzurum Nenehatun Obstetrics and Gynecology Hospital, Erzurum, Turkey.
J Matern Fetal Neonatal Med. 2021 Jun;34(11):1763-1767. doi: 10.1080/14767058.2019.1647530. Epub 2019 Jul 31.
Thrombus incidence is higher among neonates, especially in preterm infants, due to the associated additional risk factors.
The medical recordings of premature infants who had been diagnosed as having intracardiac thrombus between January 2016 and January 2019 were evaluated retrospectively. We use recombinant tissue plasminogen activator when the thrombus is relatively large compared to left atrium, pedunculated, mobile, or snake shaped.
A total of 13 premature patients were diagnosed as having intracardiac thrombus during the 3-year period. All were diagnosed during echocardiographic studies. Low molecular weight heparin was administered in four patients. In three, recombinant tissue plasminogen activator was started with low dose (0.01 mg/kg/h) and increased gradually to 0.06 mg/kg/h. In three, recombinant tissue plasminogen activators were started with standard dose (0.5 mg/kg/h). In one recombinant tissue, plasminogen activator was started with low dose (0.01 mg/kg/h) and increased to standard dose. Two patients died before treatment, three patients died during treatment, follow-up was not available for two patients, and thrombus completely resolved in six patients.
In preterm babies with risk factors, intracardiac thrombus should be kept in mind during all echocardiographic studies. In our patients, low and standard dose regimens were used, and the treatment results were similar.
由于相关的附加危险因素,新生儿,尤其是早产儿的血栓发生率较高。
回顾性评估了 2016 年 1 月至 2019 年 1 月期间被诊断为患有心内血栓的早产儿的医疗记录。当血栓相对于左心房较大、有蒂、活动或呈蛇形时,我们使用重组组织型纤溶酶原激活剂。
在 3 年期间,共有 13 名早产儿被诊断为患有心内血栓。所有病例均在超声心动图检查中诊断。4 例患者给予低分子肝素。其中 3 例以低剂量(0.01mg/kg/h)开始使用重组组织型纤溶酶原激活剂,并逐渐增加至 0.06mg/kg/h。其中 3 例以标准剂量(0.5mg/kg/h)开始使用重组组织型纤溶酶原激活剂。1 例重组组织型纤溶酶原激活剂以低剂量(0.01mg/kg/h)开始,逐渐增加至标准剂量。2 例患者在治疗前死亡,3 例患者在治疗期间死亡,2 例患者随访不可用,6 例患者血栓完全溶解。
在有危险因素的早产儿中,应在所有超声心动图检查中注意心内血栓。在我们的患者中,使用了低剂量和标准剂量方案,治疗结果相似。