Honma H, Kaji H, Kobayashi T, Yasuno Y, Saito K, Bossnev W, Fujino A, Tsutsui T
Health Examination Center, Iwamizawa Rosai Hospital, Iwamizawa, Japan.
Int J Occup Med Environ Health. 2000;13(4):275-86.
Hand-arm vibration syndrome (HAVS) is primarily a disorder of the fingers and hands. However, in some cases, vibration-exposed workers are observed to have also episodic blanching of the hands and feet. In latter cases, arteriographies of both the upper and lower extremities are necessary to diagnose the background arterial disorders. In this study, eight HAVS subjects with such disorders were examined by arteriography for differential diagnosis in cases of workers' accident compensation. In three HAVS cases with thromboangiitis obliterans, the arteriographic examination revealed obstructive changes in the palm and forearm as well as three below-knee lesions in the lower extremities. In five HAVS cases with arteriosclerosis obliterans, obstruction kinking or coiling, stenosis and/or tapering-off of the proper digital arteries were observed together with two below-knee lesions and three high lesions in the lower extremities. From the viewpoint of occupational health, palpation of superficial arteries of both the upper and lower extremities should be routinely performed during both pre-placement and periodic medical examinations for workers exposed to vibrating tools for early detection and/or prevention of any worsening of the background disorders.
手臂振动综合征（HAVS）主要是一种手指和手部的疾病。然而，在某些情况下，观察到接触振动的工人也会出现手脚间歇性发白。在后一种情况下，需要对上下肢进行动脉造影以诊断潜在的动脉疾病。在本研究中，对8名患有此类疾病的手臂振动综合征患者进行了动脉造影检查，以便在工伤赔偿案件中进行鉴别诊断。在3例血栓闭塞性脉管炎的手臂振动综合征病例中，动脉造影检查显示手掌和前臂有阻塞性改变，下肢有3处膝下病变。在5例动脉硬化闭塞症的手臂振动综合征病例中，观察到指固有动脉有阻塞、扭结或盘绕、狭窄和/或逐渐变细，下肢有2处膝下病变和3处高位病变。从职业健康的角度来看，在对接触振动工具的工人进行上岗前和定期体检时，应常规对手臂和下肢的浅表动脉进行触诊，以便早期发现和/或预防潜在疾病的任何恶化。
