Winthrop A L, Wesson D E
J Pediatr Surg. 1984 Oct;19(5):536-8. doi: 10.1016/s0022-3468(84)80098-6.
Urokinase was used to clear occluded silastic central venous catheters in 14 pediatric patients. The catheters, which had been placed into a neck vein and tunnelled out through the skin of the anterior chest wall, were being used for either long-term parenteral nutrition or chemotherapy. Occluded catheters that could not be cleared by simple flushing with heparinized saline were filled with a solution of urokinase, which was left in place for 2 hours before the catheter was flushed a second time. Twenty-one occluded catheters were managed in this way over a period of 14 months. There were no allergic reactions or bleeding complications. Twelve of the 21 occluded catheters were immediately cleared. Three catheters ruptured during attempted flushing maneuvers but were patent after repair. Two catheters remained partially occluded. Only four catheters were removed because of persistent occlusion. When simpler techniques fail, urokinase instillation appears a safe and effective alternative to the more common practice of removing occluded central venous catheters in children.
尿激酶用于清除14例儿科患者堵塞的硅橡胶中心静脉导管。这些导管经颈静脉置入，在前胸壁皮肤处穿出，用于长期肠外营养或化疗。不能用肝素盐水简单冲洗通畅的堵塞导管，用尿激酶溶液充盈，留置2小时后再次冲洗导管。在14个月的时间里，用这种方法处理了21根堵塞的导管。未发生过敏反应或出血并发症。21根堵塞导管中有12根立即通畅。3根导管在冲洗操作时破裂，但修复后通畅。2根导管仍部分堵塞。仅4根导管因持续堵塞而拔除。当更简单的技术无效时，对于儿童堵塞的中心静脉导管，灌注尿激酶似乎是一种安全有效的替代常规拔除方法。
