与长期内置的中央静脉导管相关的闭塞和血栓的管理
Jacquelyn L Baskin1, Ching-Hon Pui, Ulrike Reiss
1Department of Oncology and International Outreach Program, St Jude Children's Research Hospital, Memphis, TN 3105-2794, USA.
Lancet (London, England)
|July 15, 2009
概括
中枢静脉导管 (CVCs) 可以被堵塞或形成血栓,需要特殊的治疗,如血栓阻塞的血栓治疗药物. 预防策略侧重于适当的导管放置和感染控制,目前不建议使用抗凝血预防.
科学领域:
- 血管医学 血管医学
- 干预性放射学 干预性放射学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 长期的中央静脉导管 (CVC) 对于治疗慢性疾病至关重要,但容易出现并发症.
- 导管封闭和导管相关的血栓是影响心血管功能和患者健康的常见问题.
研究的目的:
- 审查和总结CVC闭塞和导管相关血栓的管理策略.
- 讨论这些CVC并发症的风险因素,诊断方法和治疗选择.
主要方法:
- 文献综述总结了关于CVC封闭和血栓形成管理的当前证据.
- 对诊断技术的分析,包括多普勒超声波和静脉图.
- 对治疗方式的评估,包括血栓消化疗法和抗凝药.
主要成果:
- 机械 CVC 闭塞需要根据具体原因进行量身定制的治疗.
- 血栓塞栓通常对抗血栓的药物,如阿尔特普拉斯反应良好.
- 导管相关的血栓与先前感染和错位等因素有关,可能导致肺栓塞等严重后果.
结论:
- CVC 闭塞和血栓的有效管理需要有针对性的治疗.
- 预防措施,如适当的CVC放置和感染控制至关重要.
- 虽然血栓溶解性预防在预防心血管感染和血栓形成方面表现有前途,但需要进一步的研究和成本效益研究.
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