Thomas D, Jaeger U, Sagoschen I, Lamberti C, Wilhelm K
Radiologische Universitätsklinik, Universität Bonn, Bonn, Germany.
Cardiovasc Intervent Radiol. 2009 Jan;32(1):155-8. doi: 10.1007/s00270-008-9361-1. Epub 2008 May 28.
Hydrofluoric acid (HF) is a colorless corrosive acid used in different industrial branches. Exposure to HF typically results from spills, and most often the hand or fingers are involved. Tissue damage through cutaneous HF exposure occurs through corrosive burns due to the free hydrogen ions and through skin penetration of the fluoride ions, causing a depletion of calcium in the deep tissue layers, ultimately leading to cell death and tissue necrosis. Treatment of HF burns consists of thoroughly flushing the exposed area with water and applying calcium gluconate gel to the skin. If topical treatment does not suffice, subcutaneous injections, as well as intravascular--both intravenous and intra-arterial--calcium gluconate therapy, have been advocated. We report for the first time a case of HF burn of the hand and digits associated with vasospasm. Pain and vasospasm were successfully treated by repeated intra-arterial calcium gluconate injection. We conclude that intra-arterial calcium gluconate injection is a successful and well-tolerated therapy for HF burn associated with Raynaud's syndrome. Intra-arterial injection allows for well-controlled delivery of therapy as well as assessment of the vascular status.
氢氟酸（HF）是一种无色腐蚀性酸，用于不同的工业部门。接触氢氟酸通常是由于泄漏引起的，最常见的是手部或手指接触。皮肤接触氢氟酸导致的组织损伤是由游离氢离子引起的腐蚀性烧伤以及氟离子穿透皮肤所致，从而导致深层组织层中的钙耗尽，最终导致细胞死亡和组织坏死。氢氟酸烧伤的治疗包括用水彻底冲洗暴露区域，并在皮肤上涂抹葡萄糖酸钙凝胶。如果局部治疗不足，有人主张进行皮下注射以及血管内（静脉内和动脉内）葡萄糖酸钙治疗。我们首次报告了一例与血管痉挛相关的手部和手指氢氟酸烧伤病例。通过反复动脉内注射葡萄糖酸钙成功治疗了疼痛和血管痉挛。我们得出结论，动脉内注射葡萄糖酸钙是治疗与雷诺综合征相关的氢氟酸烧伤的一种成功且耐受性良好的疗法。动脉内注射可以很好地控制治疗的给药以及评估血管状况。
