Fukui A, Maeda M, Mine T, Inada Y, Mizumoto S, Tamai S
Department of Orthopedic Surgery, Omiwa Hospital, Nara, Japan.
Microsurgery. 1992;13(2):62-6. doi: 10.1002/micr.1920130203.
Seven patients with trauma to eight digits and one toe went untreated for arterial stasis, with subsequent development of posttraumatic changes in skin coloration. In two patients involving two digits, a daily dose of 2,000 ml containing 240,000 U urokinase, 80 micrograms prostaglandin E1, and 10,000 U heparin in lactated Ringer's solution was administered by intravenous infusion for 10 consecutive days; one of the two digits became necrotic. In all subsequent patients, a daily dose of 80 ml containing 240,000 U urokinase, 40 micrograms prostaglandin E1, 10,000 U (maximum) heparin, and low-molecular-weight dextran was administered by continuous local intraarterial infusion for 10 consecutive days. These seven extremities survived, even in the case of two digits and one toe with over 50 hr of arterial stasis. We believe that revascularization of extremities following prolonged periods of arterial stasis may be possible by means of continuous local intraarterial infusion of antithrombotic agents.
7例8指1趾外伤患者因动脉淤滞未接受治疗，随后出现创伤后皮肤颜色改变。在2例累及2指的患者中，将每日剂量2000 ml含240000 U尿激酶、80微克前列腺素E1和10000 U肝素的溶液加入乳酸林格液中，静脉输注，连续10天；其中1指发生坏死。在随后的所有患者中，将每日剂量80 ml含240000 U尿激酶、40微克前列腺素E1、10000 U（最大量）肝素和低分子右旋糖酐的溶液通过持续局部动脉内输注，连续10天。这7个肢体均存活，即使是2指1趾动脉淤滞超过50小时的病例。我们认为，通过持续局部动脉内输注抗血栓药物，长时间动脉淤滞后肢体的血管再通是可能的。
