Thrombolytische Therapieformen im Kindesalter

H. G. Kehl; H. Vielhaber; Ulrike Nowak-Göttl

doi:10.1055/s-0038-1656659

Hämostaseologie, Inhaltsverzeichnis

Hamostaseologie 1996; 16(04): 212-216
DOI: 10.1055/s-0038-1656659

Übersichtsarbeiten/Review Articles

Schattauer GmbH

Thrombolytische Therapieformen im Kindesalter

Eine Übersicht

H. G. Kehl

¹Westfälische Wilhelms-Universität Münster, Klinik und Poliklinik für Kinderheilkunde, Kardiologie (Direktor: Prof. Dr. med. J. Vogt)

,

H. Vielhaber

¹Westfälische Wilhelms-Universität Münster, Klinik und Poliklinik für Kinderheilkunde, Kardiologie (Direktor: Prof. Dr. med. J. Vogt)

,

Ulrike Nowak-Göttl

¹Westfälische Wilhelms-Universität Münster, Klinik und Poliklinik für Kinderheilkunde, Kardiologie (Direktor: Prof. Dr. med. J. Vogt)

› Institutsangaben

Abstract

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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.

Schlüsselwörter

Thrombolyse - Thrombose - Embolie - Kinder

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Referenzen

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