Curnow A, Idowu J, Behrens E, Toomey F, Georgeson K
Arch Surg. 1985 Nov;120(11):1237-40. doi: 10.1001/archsurg.1985.01390350023006.
Among the serious complications encountered with long-term, indwelling Silastic central venous catheters are catheter-induced intravascular thrombi. These thrombi are usually treated by removal of the catheter to prevent thrombus propagation, embolization, or infection. We treated ten patients with urokinase infusion who had experienced 12 incidents of induced intravascular thrombi. Catheter phlebography and two-dimensional echocardiography were used for diagnosis and follow-up. Eleven of the 12 episodes were treated successfully, with complete dissolution of the thrombus. One patient with a calcific thrombus had only partial clot lysis and required catheter removal. By utilizing urokinase infusion to treat Silastic catheter-induced intravascular thrombi, nine of ten central venous catheters were preserved and the possible need for thrombectomy was averted. No serious complications were encountered. In our experience, urokinase therapy has been an effective and safe method for treating Silastic catheter-induced intravascular thrombi.
长期留置硅橡胶中心静脉导管所遇到的严重并发症包括导管引起的血管内血栓形成。这些血栓通常通过拔除导管来治疗，以防止血栓扩展、栓塞或感染。我们对10例发生过12次导管引起的血管内血栓形成事件的患者进行了尿激酶输注治疗。导管静脉造影和二维超声心动图用于诊断和随访。12次发作中有11次治疗成功，血栓完全溶解。1例有钙化血栓的患者仅部分血栓溶解，需要拔除导管。通过利用尿激酶输注治疗硅橡胶导管引起的血管内血栓形成，10根中心静脉导管中有9根得以保留，避免了可能需要的血栓切除术。未遇到严重并发症。根据我们的经验，尿激酶治疗是治疗硅橡胶导管引起的血管内血栓形成的一种有效且安全的方法。
