Brismar B, Hårdstedt C, Malmborg A S
Acta Chir Scand. 1980;146(2):115-9.
A total of 42 central venous catheterizations in 32 patients were subjected to a prospective study with respect to bacteriologic and thrombotic complications. Growth of bacteria was found in blood cultures in 3 cases (7%) and in cultures from catheter tips in 15 cases (36%). In 25 cases (59%) phlebography revealed partial or complete thrombosis of the central vein. In 7 cases phlebography could not be performed because of blockage of the catheter (5 cases) or thrombophlebitis (2 cases). There was no relationship between bacteriologic and thrombotic complications. The frequency of bacteraemia is in agreement with earlier observations whereas the frequency of catheter-related thrombosis is much higher. This might be due to the fact that phlebography was performed at the time of catheter removal. The presence of catheter-related thrombosis is potentially hazardous as a source of microembolism. Prophylactic anticoagulant therapy in long-term catheterizations for parenteral nutrition is therefore suggested.
对32例患者的42次中心静脉置管进行了一项关于细菌学和血栓形成并发症的前瞻性研究。血培养中发现3例（7%）有细菌生长，导管尖端培养中发现15例（36%）有细菌生长。静脉造影显示25例（59%）中心静脉有部分或完全血栓形成。7例因导管堵塞（5例）或血栓性静脉炎（2例）无法进行静脉造影。细菌学和血栓形成并发症之间没有关系。菌血症的发生率与早期观察结果一致，而导管相关血栓形成的发生率要高得多。这可能是因为在拔除导管时进行了静脉造影。导管相关血栓形成作为微栓塞源具有潜在危险性。因此建议对长期进行肠外营养的置管患者进行预防性抗凝治疗。
