Lenarz T, Gülzow J, Haels J
Laryngol Rhinol Otol (Stuttg). 1987 May;66(5):283-5.
We report on a 52-year-old female patient who developed a thrombophlebitis with consecutive thrombosis of the internal jugular vein 14 days after hemicolectomy and prolonged central venous catheterisation. The tip of the polyethylene catheter was placed in the internal jugular vein. The pathophysiology of the thrombotic inflammation can be related to local alterations of the vessel wall due to mechanical irritation as well as hyperosmotic solutions on one side and bacterial infection on the other. The life threatening complications such as septicaemia, diffuse embolisation of other organs and the development of superior vena cava syndrome can be prevented only by instantaneous surgical removal of the jugular vein. Additionally, antibiotic and highdose heparine therapy are necessary. A review of the literature supports our experience.
我们报告了一名52岁女性患者,该患者在半结肠切除术后14天因长期中心静脉置管出现血栓性静脉炎,并继而发生颈内静脉血栓形成。聚乙烯导管尖端置于颈内静脉内。血栓性炎症的病理生理学可能与血管壁一侧因机械刺激和高渗溶液导致的局部改变以及另一侧的细菌感染有关。只有通过立即手术切除颈静脉,才能预防诸如败血症、其他器官的弥漫性栓塞和上腔静脉综合征等危及生命的并发症。此外,抗生素和大剂量肝素治疗是必要的。文献综述支持了我们的经验。