Department of Pediatrics.
Department of Radiodiagnosis.
J Pediatr Hematol Oncol. 2024 Oct 1;46(7):e544-e549. doi: 10.1097/MPH.0000000000002923. Epub 2024 Jul 22.
Our objective was to study the proportion of children developing Catheter-related thrombosis (CRT) following central venous Catheter (CVC) insertion and the risk factors of CRT in pediatric patients with CVC. One hundred four children aged 29 days to 18 years who had a percutaneous non-tunneled CVC inserted were enrolled. Ultrasonogram (USG) with venous Doppler scan was performed within 48 hours of CVC removal to diagnose CRT. The major indications for CVC insertion were surgical care 34 (32.6%) and ICU care 28(26.9%). The median age of the patients was 3 years, and 75% were males. The median number of CVC days was 10 (IQR 5.15). CRT was seen in 45(43.3%), of which 33 (73.3%) were asymptomatic. The rate of CRT was 35.69 cases per 1000 CVC days (95% CI 26.03-47.75). The number of days a catheter was in place and USG-guided catheter insertion was a significant risk factor. The multivariate logistic regression model showed that the duration of CVC in situ was independently associated with the development of CRT (OR, 1.06; 95% CI 1.0-1.1; P =0.02). CVC duration was a major risk factor for the development of CRT. There was a higher risk of developing a symptomatic CRT with central venous catheters than hemodialysis sheaths.
我们的目的是研究中心静脉导管（CVC）置管后儿童发生导管相关性血栓形成（CRT）的比例，以及儿童 CVC 患者 CRT 的危险因素。共纳入 104 例年龄 29 天至 18 岁行经皮非隧道 CVC 置管的患儿。CVC 拔除后 48 小时内行超声（USG）联合静脉多普勒扫描检查以诊断 CRT。CVC 置管的主要适应证为外科治疗 34 例（32.6%）和 ICU 治疗 28 例（26.9%）。患儿的中位年龄为 3 岁，75%为男性。CVC 留置时间的中位数为 10 天（IQR 5.15）。45 例（43.3%）患儿发生 CRT，其中 33 例（73.3%）为无症状。CRT 的发生率为每 1000 个 CVC 日 35.69 例（95%CI 26.03-47.75）。导管留置时间和 USG 引导下导管插入是 CRT 发生的显著危险因素。多变量 logistic 回归模型显示，CVC 在位时间与 CRT 的发生独立相关（OR，1.06；95%CI 1.0-1.1；P =0.02）。CVC 在位时间是 CRT 发生的主要危险因素。与血液透析套管相比，中心静脉导管发生症状性 CRT 的风险更高。
