Smith V C, Hallett J W
South Med J. 1983 May;76(5):603-6. doi: 10.1097/00007611-198305000-00018.
The purpose of this study was to determine the immediate and long-term complications of subclavian vein thrombosis occurring during prolonged catheterization for parenteral nutrition. Ten cases of subclavian vein thrombosis documented by venography were initially treated by catheter removal, systemic heparin, and upper extremity elevation. Although fever was common (N = 9), only three patients had positive blood or catheter cultures and only one patient required antibiotic therapy. Nonfatal pulmonary embolism was suspected by lung scan in only one patient. After a follow-up period of six months to five years (mean two years), no long-term disability, such as arm swelling or pain, was identified. We conclude that immediate and late sequelae of catheter-associated subclavian vein thrombosis are minimized by prompt removal of the catheter, systemic administration of heparin to prevent clot propagation and embolism, and arm elevation to reduce early upper extremity edema.
本研究的目的是确定在长期进行肠外营养导管插入术期间发生的锁骨下静脉血栓形成的近期和远期并发症。经静脉造影证实的10例锁骨下静脉血栓形成患者最初采用拔除导管、全身应用肝素以及抬高上肢进行治疗。尽管发热很常见（n = 9），但只有3例患者血培养或导管培养呈阳性，仅1例患者需要抗生素治疗。仅1例患者经肺部扫描怀疑有非致命性肺栓塞。经过6个月至5年（平均2年）的随访期，未发现诸如手臂肿胀或疼痛等长期残疾情况。我们得出结论，通过及时拔除导管、全身应用肝素以防止血栓扩展和栓塞以及抬高上肢以减轻早期上肢水肿，可将与导管相关的锁骨下静脉血栓形成的近期和远期后遗症降至最低。
