Yagi K, Kawakami M, Sugimoto T
Department of Traumatology, Osaka University Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1988 Dec;89(12):1943-9.
Septic complication is one of the major problems associated with central venous catheterization. Thrombi produced around a catheter are regarded to a predisposing factor. However, few reports have focused on thrombus formation in clinical settings. We studied prospectively thrombus formation associated with central venous catheterization in 56 patients. Thrombus formation was identified in 39 cases (70%). In most cases, this thrombi formed around a catheter and were released into stream when the catheter was removed. However, complications attributable to the thrombi, such as pulmonary embolism were not observed. Then we tested four materials of catheters including vinylchloride, vinylchloride coated with heparine, polyurethane, and silicone to compare the incidence of thrombus formation. Thrombi were found regardless the catheter material when they were placed for more than 10 days. Cultures of blood, catheter tips and parts of catheters placed under the skin were performed to clarify the relation between thrombus formation and catheter-related sepsis. Positive culture was obtained only five cases but they were all associated with thrombus formation. These results suggest that central venous catheterization frequently results in thrombus formation, which would lead to catheter-related spesis.
感染性并发症是与中心静脉置管相关的主要问题之一。导管周围形成的血栓被认为是一个诱发因素。然而，很少有报告关注临床环境中的血栓形成。我们对56例患者中心静脉置管相关的血栓形成进行了前瞻性研究。在39例（70%）中发现了血栓形成。在大多数情况下，这些血栓在导管周围形成，并在拔除导管时被冲入血流。然而，未观察到由血栓引起的并发症，如肺栓塞。然后我们测试了四种导管材料，包括氯乙烯、涂有肝素的氯乙烯、聚氨酯和硅胶，以比较血栓形成的发生率。当导管放置超过10天时，无论导管材料如何都发现了血栓。对血液、导管尖端和置于皮下的导管部分进行培养，以阐明血栓形成与导管相关败血症之间的关系。仅在5例中获得阳性培养结果，但它们均与血栓形成有关。这些结果表明，中心静脉置管经常导致血栓形成，这可能会导致导管相关败血症。
