Kaufman J, Demas C, Stark K, Flancbaum L
West J Med. 1986 Aug;145(2):200-3.
Central venous catheter-related infection and evidence for central venous thrombosis developed in five patients. On the basis of ongoing bacteremia after catheter removal and venographic confirmation, catheter-related septic central venous thrombosis (CR-SCVT) was confirmed. These patients were treated successfully with anticoagulation and antibiotics; none required surgical exploration or drainage.CR-SCVT is a complication of modern venous access techniques and is easily confused with sepsis from other anatomic sites. Even when recognized antemortem, CR-SCVT carries an excessive morbidity and mortality. The therapy for this complication is not standardized, but catheter removal, anticoagulation and a prolonged course of antibiotics are appropriate initial therapy. Surgical vein ligation or excision are reserved for refractory sepsis or abscess formation.
5例患者发生了中心静脉导管相关感染及中心静脉血栓形成的证据。基于拔除导管后持续的菌血症及静脉造影证实,确诊为导管相关感染性中心静脉血栓形成(CR-SCVT)。这些患者经抗凝及抗生素治疗成功;无人需要手术探查或引流。CR-SCVT是现代静脉通路技术的一种并发症,容易与其他解剖部位的脓毒症相混淆。即使在生前被识别,CR-SCVT也具有较高的发病率和死亡率。这种并发症的治疗尚无标准化方案,但拔除导管、抗凝及延长抗生素疗程是合适的初始治疗。手术静脉结扎或切除适用于难治性脓毒症或脓肿形成。