Acevedo A, Palma S, Guzmán L, Grisanti M, Basualdo J, Cerda C, Toledo L, Díaz J
Servicio de Cirugía, Hospital del Salvador, Santiago de Chile.
Rev Med Chil. 1991 Apr;119(4):412-7.
Treatment of severe hand ischemia a associated to progressive systemic sclerosis and other disorders is controversial. We studied prospectively 45 patients, 41 female and 4 males, over an 11 year period. Age ranged from 16 to 73 years, mean 46. Underlying disease was systemic sclerosis in 30, CREST in 8, overlapping syndrome in 4, systemic lupus in 1 and non rheumatic vasculitis in 2 patients. Treatment consisted of intravenous injection of reserpine, 1 mg, at a superficial arm vein after controlled local circulatory block for 15 min. Regional anesthesia was required in 38 patients. Adequate follow up was obtained in 32 females and 2 males, receiving a mean of 3.1 therapy sessions (range 1 to 13). Morphologic improvement from 3.09 +/- 0.16 to 1.57 +/- 0.13 and functional improvement from 3.6 +/- 0.12 to 1.75 +/- 0.14 (5 grade scoring system), was observed (p < 0.001). These results correlate with adequate rehabilitation confirmed clinically.
与进行性系统性硬化症及其他疾病相关的严重手部缺血的治疗存在争议。我们在11年期间对45例患者进行了前瞻性研究，其中41例女性，4例男性。年龄范围为16至73岁，平均46岁。基础疾病为系统性硬化症30例，CREST综合征8例，重叠综合征4例，系统性红斑狼疮1例，非风湿性血管炎2例。治疗方法为在局部循环阻滞15分钟后，于上臂浅静脉静脉注射1毫克利血平。38例患者需要区域麻醉。32例女性和2例男性获得了充分随访，平均接受3.1次治疗（范围1至13次）。观察到形态学评分从3.09±0.16改善至1.57±0.13，功能评分从3.6±0.12改善至1.75±0.14（5级评分系统）（p<0.001）。这些结果与临床证实的充分康复相关。
