Girod D A, Hurwitz R A, Caldwell R L
Pediatr Cardiol. 1982;3(2):175-80. doi: 10.1007/BF02312966.
One thousand three hundred and sixteen consecutively catheterized infants and children were evaluated prospectively for femoral artery thrombosis following percutaneous cardiac catheterization. One hundred units/kg heparin bolus was given to 649 patients after arterial puncture (group A). A supplementary 50 units/kg of heparin bolus was given to 381 patients 75 minutes later, followed by a continuous heparin infusion if pulses were decreased (group B). Two hundred forty-one patients were managed similarly except the first supplementary bolus was given 45 minutes after initial heparinization, if necessary, and the second bolus and continuous infusion were begun 45 minutes later, if necessary (group C). Arterial thrombosis was diagnosed if pulses were not equal to those of the unused extremity 6 hours following catheterization. The overall incidence of arterial thrombosis was 0.8%. No statistically significant (p less than .05) differences occurred related to the heparinization method used. However, absence of thrombosis in the last 241 consecutive patients (group C) and in the last 480 patients of groups B and C weighing more than 10 kg approaches significance (p less than .1). Incidence of thrombosis was less than in previous studies (p less than .0005 to .05). This study indicates that a very low incidence of arterial thrombosis can be achieved with systemic heparinization.
对1316例接受经皮心脏导管插入术的婴幼儿进行前瞻性评估，以观察股动脉血栓形成情况。动脉穿刺后，649例患者给予100单位/千克肝素推注（A组）。381例患者在75分钟后给予追加的50单位/千克肝素推注，若脉搏减弱则随后给予肝素持续输注（B组）。241例患者的处理方式类似，但首次追加推注在初始肝素化后45分钟给予（必要时），第二次推注和持续输注在45分钟后（必要时）开始（C组）。如果导管插入术后6小时患侧脉搏与未使用肢体的脉搏不相等，则诊断为动脉血栓形成。动脉血栓形成的总体发生率为0.8%。使用的肝素化方法之间未出现统计学显著差异（p<0.05）。然而，最后连续241例患者（C组）以及B组和C组中最后480例体重超过10千克的患者未发生血栓形成，接近显著水平（p<0.1）。血栓形成的发生率低于先前研究（p<0.0005至0.05）。本研究表明，全身肝素化可实现极低的动脉血栓形成发生率。
