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Hamostaseologie 1996; 16(04): 212-216
DOI: 10.1055/s-0038-1656659
DOI: 10.1055/s-0038-1656659
Übersichtsarbeiten/Review Articles
Thrombolytische Therapieformen im Kindesalter
Eine ÜbersichtWeitere Informationen
Publikationsverlauf
Publikationsdatum:
24. Juli 2018 (online)
Zusammenfassung:
Thrombosen und Embolien sind im Kindesalter nicht zu unterschätzen. Typische Ursachen sind zentrale Katheter, Herzkatheteruntersuchungen mit Intervention, größere operative Eingriffe neben primären oder sekundären Mangelzuständen von Gerinnungsinhibitoren. Geschätzt wird eine Inzidenz von etwa 5 auf 10000 hospitalisierte Kinder mit einer Mortalität von 2%, einer Rezidivrate von 7-18% sowie der Entwicklung postthrombotischer Syndrome in 20% der Fälle. Die Erfahrungen mit thrombolytischen Therapieformen im Kindesalter sind begrenzt. In mehreren Studien gut dokumentiert sind Thrombolysen von akuten Verschlüssen der Femoralarterien nach Herzkatheruntersuchungen: In 10 Studien wurden 147 von 164 (90%) Patienten erfolgreich lysiert, lokale Blutungen traten bei 41 von 164 (25%) auf. Auf kleinere Studien begrenzt sind Therapien von Thrombosen in den Nierenvenen, den zentralvenösen Gefäßen sowie im rechten Atrium. Erfahrungen mit Lysen linksatrialer, linksventrikulärer oder aortaler Thrombosen sowie Lungenembolien im Kindesalter liegen bisher nur in Form von Kasuistiken vor.
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