De Schepper J, Hachimi-Idrissi S, Cham B, Bougatef A, De Wolf D, Desprechins B, Sacre L
Department of Pediatrics, Academisch Ziekenhuis, Vrije Universiteit, Brussels, Belgium.
Am J Perinatol. 1993 Jan;10(1):39-42. doi: 10.1055/s-2007-994698.
Infected right atrial thrombosis is an uncommon but severe complication of the use of central indwelling catheters in children. Massive thrombi around a right atrial catheter were seen in two critically ill premature infants after 3 weeks of parenteral nutrition. A catheter-related sepsis had previously occurred and had been treated by antibiotics. Subsequently, protracted thrombocytopenia, fluctuating hepatomegaly, and increasing respiratory distress were found in both cases. A right atrial mass was detected by 2 dimensional echocardiography. Cardiotomies for removal of the infected thrombus were performed with success in both cases. In one infant, weighing only 900 gm, surgical removal was accomplished with the aid of inflow stasis. Premature infants with catheter-related sepsis appear at greater risk for intracardiac thrombosis and should undergo echocardiography as part of their evaluation. Infected atrial thrombi can be safely removed by cardiotomy even in the very small premature infant.
感染性右房血栓形成是儿童使用中心留置导管时一种罕见但严重的并发症。在两名危重新生儿经3周胃肠外营养后，发现右房导管周围有大量血栓。此前发生过与导管相关的败血症，并已用抗生素治疗。随后，两例患儿均出现持续性血小板减少、肝脏肿大波动以及呼吸窘迫加重。二维超声心动图检测到右房肿块。两例均成功进行了心脏切开术以清除感染性血栓。在一名体重仅900克的婴儿中，借助入流停滞成功完成了手术切除。患有与导管相关败血症的早产儿发生心内血栓形成的风险似乎更高，应进行超声心动图检查作为评估的一部分。即使是非常小的早产儿，通过心脏切开术也可安全地清除感染性心房血栓。
