Strife J L, Ball W S, Towbin R, Keller M S, Dillon T
Division of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
Radiology. 1988 Feb;166(2):395-400. doi: 10.1148/radiology.166.2.3336714.
For neonates with ischemia of an extremity or extensive thrombosis of the aorta after umbilical artery catheterization, prompt recognition and management decisions are necessary. The cases of eight infants with symptomatic thrombosis who were treated with fibrinolytic agents were retrospectively reviewed to study means of diagnosis and response to therapy. Peripheral thrombosis was seen in two otherwise healthy infants; fibrinolytic therapy produced complete lysis in one and partial lysis in the other. The six infants with central thrombosis presented with low Apgar scores and multiple clinical problems; umbilical catheters were already in place. To assess the clot, real-time sonography was performed in all six patients, and umbilical arteriograms were obtained in five. Fibrinolytic therapy produced complete lysis of clot in five of the six infants. The one death occurred in a premature infant in whom a large intracranial hemorrhage developed 6 hours after institution of therapy.
对于脐动脉插管后出现肢体缺血或主动脉广泛血栓形成的新生儿，必须迅速识别并做出管理决策。回顾性分析了8例接受纤溶药物治疗的有症状血栓形成婴儿的病例，以研究诊断方法和对治疗的反应。在另外两名健康婴儿中发现了外周血栓形成；纤溶治疗使其中一名婴儿的血栓完全溶解，另一名部分溶解。6例中心性血栓形成的婴儿表现为阿氏评分低和多种临床问题；脐导管已就位。为评估血栓，对所有6例患者进行了实时超声检查，5例进行了脐动脉造影。纤溶治疗使6例婴儿中的5例血栓完全溶解。1例死亡发生在一名早产儿身上，该婴儿在治疗开始6小时后发生了大面积颅内出血。
