Sen Surjya, Chini Eduardo Nunes, Brown Michael J
Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
Mayo Clin Proc. 2005 Jun;80(6):783-95. doi: 10.1016/S0025-6196(11)61533-4.
Unintentional intra-arterial injection of medication, either iatrogenic or self-administered, is a source of considerable morbidity. Normal vascular anatomical proximity, aberrant vasculature, procedurally difficult situations, and medical personnel error all contribute to unintentional cannulation of arteries in an attempt to achieve intravenous access. Delivery of certain medications via arterial access has led to clinically important sequelae, including paresthesias, severe pain, motor dysfunction, compartment syndrome, gangrene, and limb loss. We comprehensively review the current literature, highlighting available information on risk factors, symptoms, pathogenesis, sequelae, and management strategies for unintentional intra-arterial injection. We believe that all physicians and ancillary personnel who administer Intravenous therapies should be aware of this serious problem.
意外动脉内注射药物，无论是医源性的还是自我注射的，都是相当大的发病原因。正常血管的解剖毗邻关系、血管异常、操作困难的情况以及医务人员的失误，都导致在试图建立静脉通路时意外误插入动脉。通过动脉通路输注某些药物已导致具有临床重要意义的后遗症，包括感觉异常、剧痛、运动功能障碍、骨筋膜室综合征、坏疽和肢体丧失。我们全面回顾了当前的文献，突出了关于意外动脉内注射的危险因素、症状、发病机制、后遗症和管理策略的现有信息。我们认为，所有进行静脉治疗的医生和辅助人员都应意识到这个严重问题。
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