Barzaghi A, Dell'Orto M, Rovelli A, Rizzari C, Colombini A, Uderzo C
Pediatric Department, University of Milan, Ospedale Nuovo S. Gerardo, Monza, Italy.
Pediatr Hematol Oncol. 1995 May-Jun;12(3):243-50. doi: 10.3109/08880019509029565.
In a 7-month period we studied 38 Hickman central venous catheters (CVCs) positioned in children with hematologic malignancies with the aim of evaluating the incidence and clinical impact of CVC clots. Clots were found in 74% of the CVCs. Three methods of catheter care were developed for flushing the clotted CVCs: (a) use of a heparinized solution (400 IU/mL) on alternate days, (b) use of a heparinized solution (400 IU/mL) and saline solution containing urokinase (10,000 IU/mL) on alternate days, and (c) use of a saline solution containing urokinase (10,000 IU/mL) daily. Only method b decreased clot formation (33% success rate). There were no major mechanical complications in any of the CVCs with clots. Eighteen percent of patients with clots in their CVCs presented with CVC-related infections while no infective complications were observed in the patients without clots in their CVCs. In conclusion, CVC clots may predispose the patient to infections, which must be correctly treated.
在7个月的时间里，我们研究了38根植入血液系统恶性肿瘤患儿体内的Hickman中心静脉导管（CVC），目的是评估CVC血栓的发生率及其临床影响。在74%的CVC中发现了血栓。针对堵塞的CVC，我们开发了三种导管护理方法用于冲洗：（a）隔天使用肝素化溶液（400 IU/mL）；（b）隔天使用肝素化溶液（400 IU/mL）和含尿激酶（10,000 IU/mL）的盐溶液；（c）每天使用含尿激酶（10,000 IU/mL）的盐溶液。只有方法b减少了血栓形成（成功率为33%）。有血栓的CVC均未出现严重机械并发症。18%的CVC有血栓的患者出现了与CVC相关的感染，而CVC无血栓的患者未观察到感染并发症。总之，CVC血栓可能使患者易发生感染，必须进行正确治疗。
