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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Successful treatment of a catheter-related right atrial thrombosis with recombinant tissue plasminogen activator and heparin.
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Successful treatment of a catheter-related right atrial thrombosis with recombinant tissue plasminogen activator and heparin.

机译：用重组组织纤溶酶原激活物和肝素成功治疗导管相关的右房血栓形成。

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摘要

Deep venous thrombosis is a possible complication of indwelling central venous catheters (CVC), with an incidence as high as 61%. We report a case of successful thrombolysis of a CVC-related right atrial thrombus in a pediatric cancer patient with recombinant human tissue plasminogen activator (0.1 mg/kg per h for 12 h) and heparin (10 IU/kg per h for 24 h) administered for 6 days. Daily echocardiographic examination showed progressive lysis of the thrombus. The thrombolytic treatment was associated with mild oozing from the venipuncture sites, but no major bleeding was noted; moreover, thrombin, thromboplastin time and fibrinogen were normal or only minimally altered. Anticoagulant therapy, with or without CVC removal, is the treatment of choice for uncomplicated CVC-related thrombosis. Fibrinolytic therapy may be indicated in some cases at risk of pulmonary embolism or to avoid open heart surgery. Recombinant human tissue plasminogen activator is increasingly used for thrombolytic treatment of organ and limb thrombosis, but experience with it in the pediatric hematology-oncology setting is still limited. This report showed that administering recombinant human tissue plasminogen activator in a pediatric cancer patient prior to hematopoietic stem cell transplantation was effective and safe under strict biochemical and instrumental monitoring. Further studies are needed to determine the best antithrombotic treatment for CVC-related thrombosis, and also the dosage of the medication selected and the duration of treatment.
机译：深静脉血栓形成是留置中心静脉导管（CVC）的一种可能并发症，其发生率高达61％。我们报告了一个小儿癌症患者的CVC相关右心房血栓成功溶栓的案例，该患者患有重组人组织纤溶酶原激活剂（0.1 mg / kg / h，持续12 h）和肝素（10 IU / kg / h，持续24 h）给药6天。每日超声心动图检查显示血栓逐渐溶解。溶栓治疗与静脉穿刺部位轻度渗出有关，但未见大出血。此外，凝血酶，凝血活酶时间和纤维蛋白原正常或仅有很小的改变。抗凝治疗（伴有或不伴有CVC去除）是无并发症CVC相关性血栓形成的治疗选择。在某些情况下可能会发生纤溶治疗，表明存在肺栓塞的风险或避免进行心脏直视手术。重组人组织纤溶酶原激活物越来越多地用于器官和肢体血栓形成的溶栓治疗，但在儿科血液肿瘤学领域的经验仍然有限。该报告表明，在严格的生化和仪器监测下，在造血干细胞移植之前在小儿癌症患者中使用重组人组织纤溶酶原激活剂是安全有效的。需要进一步的研究来确定针对CVC相关血栓形成的最佳抗血栓治疗方法，以及所选药物的剂量和治疗持续时间。

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