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首页> 外文期刊>Annals of Tropical Paediatrics >Neonatal thrombo-embolism: risk factors, clinical features and outcome.
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Neonatal thrombo-embolism: risk factors, clinical features and outcome.

机译：新生儿血栓栓塞：危险因素，临床特征和结局。

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BACKGROUND: There are few data with respect to prothrombotic risk factors in neonates. AIM: To determine the associated risk factors, clinical features and outcome in newborn infants diagnosed with thrombo-embolism. METHODS: Case records of 25 infants (17 full-term and eight preterm) diagnosed with thrombo-embolism between January 2005 and April 2008 in a neonatal intensive care unit were reviewed. RESULTS: Of the 25 infants, 18 cases of venous (72%) and seven of arterial (28%) thrombo-embolism were recorded; in 18 it was associated with central catheterisation. The sites of thrombosis were portal vein (15), right renal vein (one), right femoral vein (one), multiple veins (one), right femoral artery (3), right iliac artery (2), bilateral iliac and renal arteries (one) and left renal artery (one). Hereditary thrombotic mutations were detected in three patients and anticardiolipin antibody was detected in one, none of whom had been catheterised. The remaining three non-catheterised patients had perinatal risk factors. Venous catheter placement was undertaken in 12 patients (48%), eleven of whom had: umbilical venous catheterisation for exchange transfusion (9), partial exchange transfusion (one) and venous access (one), and one had femoral venous catheterisation for an angiographic study. Arterial catheterisation was undertaken in seven patients (28%) (one infant had both umbilical venous and arterial catheters) for angiographic studies (5) and blood sampling (2). Of the 18 catheterised patients (72%), thrombophilic studies were undertaken in 13 and none had abnormal results. Additional perinatal risk factors were present in 18 patients (72%) and included prematurity (8), congenital heart disease (8), septicaemia (5), dehydration (3), respiratory distress syndrome (3), polycythemia (2), meconium aspiration syndrome (one), pneumonia (one), maternal diabetes (one), necrotising enterocolitis (one) and perinatal asphyxia (one). Although most of the patients recovered after anticoagulant or fibrinolytic therapy, the five (20%) deaths were associated mainly with underlying diseases. CONCLUSION: The most important risk factor for thrombo-embolic events in neonates is placement of central catheters and some perinatal prothrombotic conditions. Nevertheless, hereditary or acquired thrombophilic risk factors may also be a cause of thrombo-embolism.
机译：背景：关于新生儿血栓形成危险因素的数据很少。目的：确定诊断为血栓栓塞的新生儿的相关危险因素，临床特征和结局。方法：回顾了2005年1月至2008年4月在新生儿重症监护室中被诊断为血栓栓塞的25例婴儿（17例足月和8例早产儿）的病例记录。结果：在这25名婴儿中，记录了18例静脉血栓栓塞（72％）和7例动脉血栓栓塞（28％）。 18岁时与中央导管插入术有关。血栓形成部位是门静脉（15），右肾静脉（一条），右股静脉（一条），多静脉（一条），右股动脉（3），右ilia动脉（2），双侧动脉和肾动脉（一）和左肾动脉（一）。在三名患者中发现了遗传性血栓突变，在其中一名患者中未检测到抗心磷脂抗体。其余三例未行导管插入术的患者具有围产期危险因素。在12例患者中进行了静脉导管置入（48％），其中11名患者进行了以下检查：脐静脉导管换血（9），部分置换血（1）和静脉通路（1），其中一名患者进行了股静脉导管造影研究。七名患者（28％）（一名婴儿同时拥有脐静脉和动脉导管）进行了动脉导管插入术，以进行血管造影研究（5）和血液采样（2）。在18例导管插入的患者中（72％），有13例进行了血栓形成性研究，均未发现异常结果。 18位患者（72％）中存在其他围产期危险因素，包括早产（8），先天性心脏病（8），败血病（5），脱水（3），呼吸窘迫综合征（3），红细胞增多症（2），胎粪吸入综合征（1），肺炎（1），母亲糖尿病（1），坏死性小肠结肠炎（1）和围产期窒息（1）。尽管大多数患者在抗凝或纤溶治疗后康复，但五（20％）例死亡主要与基础疾病有关。结论：新生儿血栓栓塞事件的最重要危险因素是放置中央导管和一些围产期血栓形成状况。然而，遗传性或获得性血栓形成危险因素也可能是血栓栓塞的原因。

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