中心静脉导管相关的大静脉血栓形成：重组组织型纤溶酶原激活剂溶栓治疗
Central venous catheter associated thrombosis of major veins: thrombolytic treatment with recombinant tissue plasminogen activator.
作者信息
Rodenhuis S, van't Hek L G, Vlasveld L T, Kröger R, Dubbelman R, van Tol R G
机构信息
Division of Clinical Oncology, The Netherlands Cancer Institute, Amsterdam.
出版信息
Thorax. 1993 May;48(5):558-9. doi: 10.1136/thx.48.5.558.
Abstract
OBJECTIVE
Major thromboses can occur in the venous system in association with central venous catheters. This usually necessitates removal of the catheter.
METHODS
The effectiveness of low dose recombinant tissue type plasminogen activator (rt-PA) in combination with heparin was assessed in patients with central venous catheter associated thrombosis.
RESULTS
In five patients, all suffering from cancer, a 5-7 day continuous infusion resulted in complete lysis of the thrombus without complications in three. In the other two patients moderately severe haemorrhage was observed with only partial lysis, of the thrombus.
CONCLUSIONS
The infusion of heparin and rt-PA is potentially effective in thrombosis related to use of central venous catheters, but the risk of haemorrhage is not inconsiderable.
摘要
目的
中心静脉导管相关的静脉系统中可能会发生严重血栓形成。这通常需要拔除导管。
方法
评估低剂量重组组织型纤溶酶原激活剂（rt-PA）联合肝素对中心静脉导管相关血栓形成患者的疗效。
结果
5例均为癌症患者，连续输注5 - 7天，3例血栓完全溶解且无并发症。另外2例出现中度严重出血，血栓仅部分溶解。
结论
肝素和rt-PA输注对中心静脉导管相关血栓形成可能有效，但出血风险不可忽视。
相似文献
1
Central venous catheter associated thrombosis of major veins: thrombolytic treatment with recombinant tissue plasminogen activator.中心静脉导管相关的大静脉血栓形成：重组组织型纤溶酶原激活剂溶栓治疗
Thorax. 1993 May;48(5):558-9. doi: 10.1136/thx.48.5.558.
2
Successful treatment of a catheter-related right atrial thrombosis with recombinant tissue plasminogen activator and heparin.重组组织型纤溶酶原激活剂与肝素成功治疗导管相关性右心房血栓形成
Support Care Cancer. 2002 Apr;10(3):253-5. doi: 10.1007/s00520-001-0328-x. Epub 2002 Jan 8.
3
Investigational use of tissue plasminogen activator (t-PA) for occluded central venous catheters.组织型纤溶酶原激活剂（t-PA）用于阻塞中心静脉导管的研究性应用。
JPEN J Parenter Enteral Nutr. 1990 May-Jun;14(3):310-1. doi: 10.1177/0148607190014003310.
4
Treatment of neonatal thrombus formation with recombinant tissue plasminogen activator: six years experience and review of the literature.重组组织型纤溶酶原激活剂治疗新生儿血栓形成：六年经验及文献综述
Arch Dis Child Fetal Neonatal Ed. 2001 Jul;85(1):F18-22. doi: 10.1136/fn.85.1.f18.
5
Thrombus in right atrium in two infants successfully treated with tissue plasminogen activator.两名婴儿右心房血栓经组织型纤溶酶原激活剂成功治疗。
Pediatr Emerg Care. 1997 Feb;13(1):37-9. doi: 10.1097/00006565-199702000-00012.
6
A novel approach to central venous catheter thrombosis in a patient with cystic fibrosis.一种针对囊性纤维化患者中心静脉导管血栓形成的新方法。
J Cyst Fibros. 2007 Nov 30;6(6):417-8. doi: 10.1016/j.jcf.2007.02.003. Epub 2007 Mar 26.
7
Use of tissue plasminogen activator (rt-PA) in young children with cancer and dysfunctional central venous catheters.组织型纤溶酶原激活剂（rt-PA）在患有癌症且中心静脉导管功能异常的幼儿中的应用。
J Pediatr Hematol Oncol. 2002 Nov;24(8):653-6. doi: 10.1097/00043426-200211000-00010.
8
Catheter-Directed Low-Dose Tissue Plasminogen Activator for Treatment of Right Atrial Thrombus Caused by a Central Venous Catheter.导管定向低剂量组织型纤溶酶原激活剂治疗中心静脉导管所致右心房血栓
Pharmacotherapy. 2015 Oct;35(10):e153-8. doi: 10.1002/phar.1645.
9
10
Successful use of tissue plasminogen activator (t-PA) in catheter-related intracardiac thrombi of two premature infants.组织纤溶酶原激活剂（t-PA）在两名早产儿导管相关心内血栓中的成功应用。
Acta Paediatr. 1998 Jun;87(6):695-8. doi: 10.1080/080352598750014148.
引用本文的文献
1
Unveiling the complexities of catheter-related thrombosis: risk factors, preventive strategies, and management.揭示导管相关血栓形成的复杂性：危险因素、预防策略及管理
J Thromb Thrombolysis. 2025 Mar;58(3):443-457. doi: 10.1007/s11239-025-03073-7. Epub 2025 Mar 5.
2
Application of Aspiration-Assisted Percutaneous Venous Removal of Right Atrial Thrombus in a Critically Ill Patient: A Case Study and Clinical Management Overview.抽吸辅助经皮静脉清除危重症患者右心房血栓的应用：病例报告及临床管理概述
Cureus. 2022 Sep 6;14(9):e28852. doi: 10.7759/cureus.28852. eCollection 2022 Sep.
3
Systemic treatments for the prevention of venous thrombo-embolic events in paediatric cancer patients with tunnelled central venous catheters.预防带隧道式中心静脉导管的儿科癌症患者发生静脉血栓栓塞事件的全身治疗。
Cochrane Database Syst Rev. 2013 Sep 11(9):CD009160. doi: 10.1002/14651858.CD009160.pub2.
4
Metastatic carcinoma of unknown primary presenting as jugular venous thrombosis.以颈静脉血栓形成表现的原发性不明转移性癌。
Case Rep Med. 2009;2009:938907. doi: 10.1155/2009/938907. Epub 2010 Jan 4.
5
Totally implantable venous catheters for chemotherapy: experience in 500 patients.用于化疗的完全植入式静脉导管：500例患者的经验
Sao Paulo Med J. 2004 Jul 1;122(4):147-51. doi: 10.1590/s1516-31802004000400003. Epub 2004 Nov 9.
6
Pulmonary embolism in parenteral nutrition.肠外营养中的肺栓塞
Arch Dis Child. 1996 Feb;74(2):95-8. doi: 10.1136/adc.74.2.95.
7
Alteplase. A reappraisal of its pharmacology and therapeutic use in vascular disorders other than acute myocardial infarction.阿替普酶。对其在急性心肌梗死以外血管疾病中的药理学及治疗应用的重新评估。
Drugs. 1995 Aug;50(2):289-316. doi: 10.2165/00003495-199550020-00007.
8
High-dose carboplatin, thiotepa and cyclophosphamide (CTC) with peripheral blood stem cell support in the adjuvant therapy of high-risk breast cancer: a practical approach.大剂量卡铂、噻替派和环磷酰胺（CTC）联合外周血干细胞支持用于高危乳腺癌辅助治疗的实用方法
Br J Cancer. 1995 Apr;71(4):857-62. doi: 10.1038/bjc.1995.165.
本文引用的文献
1
Iatrogenic superior vena cava syndrome. A new entity.医源性上腔静脉综合征。一种新的病症。
Cancer. 1984 Jul 15;54(2):376-8. doi: 10.1002/1097-0142(19840715)54:2<376::aid-cncr2820540235>3.0.co;2-r.
2
Venous thrombosis as a cause of superior vena cava syndrome. Rapid response to streptokinase.静脉血栓形成作为上腔静脉综合征的一个病因。对链激酶的快速反应。
Arch Intern Med. 1983 May;143(5):1050-2.
3
Superior vena cava obstruction syndrome: recommendations for management.上腔静脉阻塞综合征：管理建议
Cancer Treat Rev. 1985 Sep;12(3):209-18. doi: 10.1016/0305-7372(85)90038-6.
4
Rapid resolution of subclavian vein thrombosis by tissue plasminogen activator.组织型纤溶酶原激活剂使锁骨下静脉血栓快速溶解
Lancet. 1988 Apr 16;1(8590):890. doi: 10.1016/s0140-6736(88)91644-3.
5
Plasminogen activators. The old and the new.纤溶酶原激活剂。新旧对比。
Circulation. 1989 Feb;79(2):217-24. doi: 10.1161/01.cir.79.2.217.
6
Safety and efficacy of thrombolytic therapy for superior vena cava syndrome.溶栓治疗上腔静脉综合征的安全性和有效性。
Chest. 1991 Jan;99(1):54-9. doi: 10.1378/chest.99.1.54.
7
Treatment of superior vena cava thrombosis with recombinant tissue type plasminogen activator.
Chest. 1991 May;99(5):1298-301. doi: 10.1378/chest.99.5.1298.
Zotero 插件