Contrast venography in young haemophiliacs with implantable central venous access devices.
Contrast venography in young haemophiliacs with implantable central venous access devices.
复制标题
使用植入式中心静脉通路装置对年轻血友病患者进行对比静脉造影。
DOI：
10.1046/j.1365-2516.1998.00134.x
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Buchanan,GR
中科院分区：
文献类型：
--
作者：
Medeiros,D;Miller,KL;Rollins,NK;Buchanan,GR
为了评估长期使用中心静脉导管的血友病患者发生深静脉血栓的风险，我们研究了在我们中心使用植入式静脉通路装置（端口）放置超过 6 个月的血友病患者。审查医疗记录以了解导管相关并发症的病史。检查每位患者是否有血栓形成的身体痕迹。通过对比静脉造影评估血管的通畅性。在 21 名患有港口的男性中，19 名患有因子 VIII 缺乏症和 2 名因子 IX 缺乏症。 19 个端口是可评估的（即已存在超过 6 个月）。十七名患者的原始端口已就位；由于机械功能障碍 (1) 和反复感染 (1)，两个端口被更换。三个端口出现抽出或输注困难，其中两个端口已被尿激酶清除。所有 19 名患者的体格检查均正常。 19 名患者中的 13 名进行了静脉造影。其余六名患者的父母因需要外周静脉穿刺而拒绝静脉造影。一名患者在其正常导管的同侧有一个小的非闭塞性血栓，另一名患者在先前导管的部位有锁骨下静脉轻微狭窄。通过对比静脉造影可识别的临床相关上静脉系统血栓形成的总体患病率为零（95% CI，0-23%）。我们的结论是，血友病患者的血栓形成风险不如其他使用中心静脉导管的患者群体高。血栓形成的理论上的风险不应排除血友病患者使用中心静脉导管。
To assess the risk of deep vein thrombosis in Haemophiliacs with long‐term central venous catheters, we studied Haemophiliacs followed at our centre with implantable venous access devices (ports) in place for>6 months. Medical records were reviewed for a history of catheter‐related complications. Each patient was examined for physical stigmata of thrombosis. Patency of the vessels was evaluated by contrast venography. Of 21 males with ports, 19 had factor VIII deficiency and two factor IX deficiency. Nineteen ports were evaluable (i.e. were in place for>6 months). Seventeen patients have their original ports in place; two ports were replaced for mechanical dysfunction (1) and recurrent infection (1). Difficulty withdrawing or infusing occurred with three ports, two of which were cleared with urokinase. Physical examination was normal on all 19 patients. Venograms were performed in 13 of 19 patients. Parents of the remaining six patients refused venography because of the need for peripheral venipuncture. One patient had a small nonocclusive thrombus on the same side as his functioning catheter, and another had minimal narrowing of the subclavian vein at the site of a prior catheter. The overall prevalence of clinically relevant upper venous system thrombosis identifiable by contrast venography was zero (95% CI, 0–23%). We conclude that Haemophiliacs do not have as high a risk of thrombosis as other populations of patients with central venous catheters. The theoretical risk of thrombosis should not preclude use of central venous catheters in patients with Haemophilia.