Cogliati A A, Dell'Utri D, Picardi A, Testi A M, Micozzi A, Pasotti E, Rosa G
Institute of Anesthesia and Intensive Care, University of Rome, La Sapienza, Italy.
Haematologica. 1995 Sep-Oct;80(5):448-50.
The objective of this retrospective study was to evaluate the significance and complications of percutaneous central venous catheterization in pediatric patients affected by hematologic malignancies. One hundred and fifty-eight central venous catheters were inserted in 125 pediatric patients (male/female 67/58; median age: 4 years; range 10 m - 6 y.) affected by hematological malignancies. Venous access was obtained by means of a tunnelled silicone rubber Groshong catheter inserted percutaneously in the subclavian vein (91.1%), the internal jugular vein or in the femoral vein. The medial duration of catheterization was 231.8 days (range 8-1014 days). The total number of catheter days was 33,792 (92.6 years). There were no complications related to catheter insertion. Only one patient developed significant post-operative bleeding. One hundred and nine catheters (68.9%) were removed when they were no longer needed and 49 (31.1%) were removed due to complications: 6 catheter occlusions (12.2%), 7 were accidentally withdrawn (14.3%), 3 for local infections (6.1%) and 33 for catheter-related infection (67.3%). A Groshong catheter seems to provide good access to the blood stream for a long period of time with a low incidence of complications in children with acute hematological malignancies.
这项回顾性研究的目的是评估经皮中心静脉置管在患有血液系统恶性肿瘤的儿科患者中的意义及并发症。对125例患有血液系统恶性肿瘤的儿科患者（男/女67/58；中位年龄：4岁；范围10个月 - 6岁）插入了158根中心静脉导管。通过经皮在锁骨下静脉（91.1%）、颈内静脉或股静脉插入带隧道的硅胶Groshong导管来建立静脉通路。置管的平均时长为231.8天（范围8 - 1014天）。导管使用总天数为33792天（92.6年）。没有与导管插入相关的并发症。只有1例患者出现明显的术后出血。109根导管（68.9%）在不再需要时被拔除，49根（与31.1%）因并发症被拔除：6例导管堵塞（12.2%），7例意外拔出（14.3%），3例因局部感染（6.1%），33例因导管相关感染（67.3%）。对于患有急性血液系统恶性肿瘤的儿童，Groshong导管似乎能在很长一段时间内提供良好的血流通路，且并发症发生率较低。
