Tomaino Matthew M, King John, Medsger Thomas
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Suite 1010, Pittsburgh, PA 15213, USA.
J Reconstr Microsurg. 2002 May;18(4):263-8. doi: 10.1055/s-2002-30181.
Two patients with scleroderma, ischemic pain, non-healing digital ulceration, and digital arterial obstruction were successfully treated with peripheral sympathectomy and digital arterial reconstruction using a reversed small-caliber vein graft. Postoperatively, digital blood flow increased and ulceration healed in both patients. Peripheral sympathectomy alone may not adequately improve digital perfusion, when the benefits of decreased vasospasm are offset by the presence of digital arterial insufficiency. When technically feasible, digital arterial reconstruction improves digital blood flow in scleroderma patients in whom digital collateral circulation appears inadequate after sympathectomy.
两名患有硬皮病、缺血性疼痛、手指溃疡不愈合且手指动脉阻塞的患者，通过外周交感神经切除术和使用逆行小口径静脉移植物进行手指动脉重建成功得到治疗。术后，两名患者的手指血流均增加，溃疡愈合。当血管痉挛减少的益处被手指动脉供血不足抵消时，单纯的外周交感神经切除术可能无法充分改善手指灌注。在技术可行的情况下，手指动脉重建可改善硬皮病患者的手指血流，这些患者在交感神经切除术后手指侧支循环似乎不足。
