[移除卡住的导管后钙化的纤维蛋白鞘:病例报告和文献综述]。

Q4 Medicine
Marco Taurisano, Andrea Mancini, Filomena D'elia, Giuseppe Gernone, Cosma Cortese
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引用次数: 0

摘要

血液透析患者使用中心静脉导管(CVC)的比例约为 20-30%。在这种情况下,与使用 CVC 相关的并发症很常见,需要肾科医生积极处理。这些并发症包括感染性并发症以及与 CVC 故障有关的并发症。其中,与异物反应有关的导管周围纤维蛋白鞘的形成会以各种方式导致 CVC 故障。即使在移除导管后,纤维蛋白鞘仍可能留在血管腔内(幽灵纤维蛋白鞘),而且很少发生钙化。我们描述了一例血液透析患者的临床病例,该患者在拔除发生故障的卡住的 CVC 后,上腔静脉管腔内出现了钙化的管状结构,被诊断为钙化纤维蛋白鞘(CFS)。这种罕见的情况在文献中还描述过 8 例,虽然罕见,但肯定诊断不足,可能导致并发症,如 CFS 引起的败血症、肺栓塞和血管血栓。只有在有症状的病例中才应考虑治疗方法,并采用侵入性手术方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Calcified Fibrin Sheath After Stuck Catheter Removal: Case Report and Literature Review].

The prevalence of central venous catheters (CVC) in hemodialysis patients is around 20-30%. In this scenario, complications related to the use of the CVC are commonly observed, requiring active management by nephrologists. These include infectious complications as well as those related to CVC malfunction. Among the latter, the formation of a fibrin sheath around the catheter linked to foreign body reaction could cause CVC malfunction in various ways. Even after the removal of the catheter, the fibrin sheath can remain inside the vascular lumen (ghost fibrin sheath) and rarely undergo calcification. We describe the clinical case of a hemodialysis patient who, following the removal of a malfunctioning, stuck CVC, presented a calcified tubular structure in the lumen of the superior vena cava, diagnosed as calcified fibrin sheath (CFS). This rare occurrence, described in the literature in 8 other cases, although rare, is certainly underdiagnosed and can lead to complications such as sepsis resulting from CFS, pulmonary embolisms, and vascular thrombosis. Therapeutic approaches should be considered only in symptomatic cases and involve an invasive surgical approach.

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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
62
期刊介绍: Il Giornale Italiano di Nefrologia (GIN) è la rivista di educazione continua della Società Italiana di Nefrologia SIN ed è pubblicato bimestralmente. E" il più autorevole organo di informazione nefrologia disponibile a livello nazionale. Il giornale Italiano di Nefrologia offre la più aggiornata informazione medico-scientifica rivolta al nefrologo sotto forma di rassegne, casi clinici e articoli finalizzati all’Educazione Continua in Medicina, oltre ai notiziari ed agli atti dei congressi di questa prestigiosa Società Scientifica
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