Muckart D J, Neijenhuis P A, Madiba T E
Department of Surgery, University of Natal, Durban.
S Afr J Surg. 1998 May;36(2):48-51.
Although venous thrombosis is a common sequela of central venous catheterisation, the vast majority of patients remain asymptomatic. Possible aetiological factors include catheter material, catheter-related sepsis, endothelial trauma, osmotic injury, and hypercoagulable states. Of these, only the first and last have been proven to increase the incidence. Thrombosis of the great veins of the thorax is a rare but life-threatening complication and the diagnosis is suggested by swelling of the head, upper limbs, and torso. Mediastinal widening on plain chest radiography may precede these signs. Confirmation of thrombosis is best achieved using contrast venography or contrast-enhanced CT scan. Acute symptomatic thrombosis is probably best treated by thrombolytic agents, but anticoagulation remains the commonest therapeutic approach.
尽管静脉血栓形成是中心静脉置管常见的后遗症，但绝大多数患者仍无症状。可能的病因包括导管材料、导管相关脓毒症、内皮损伤、渗透损伤和高凝状态。其中，只有第一个和最后一个已被证明确实会增加发病率。胸部大静脉血栓形成是一种罕见但危及生命的并发症，头部、上肢和躯干肿胀提示该诊断。胸部平片上纵隔增宽可能先于这些体征出现。血栓形成的确诊最好采用静脉造影或增强CT扫描。急性症状性血栓形成可能最好用溶栓剂治疗，但抗凝仍然是最常见的治疗方法。
