Hodara M
Service des maladies cardio-vasculaires, Hôpital Cochin, Paris.
Phlebologie. 1989 Apr-Jun;42(2):293-8.
Stress phlebitis of the upper extremity is in fact due to compression of the subclavian vein in the costo-clavicular space during certain movements, the effort being only a fortuitous component. Clinically, it evolves in two stages: at the stage of intermittent compression, the functional symptoms are related to certain positions of the upper extremity; the compression is identified clinically and with additional tests. Treatment includes physical therapy; however, persistence of the symptoms may result in having to consider the resection of the first rib. At the stage of organized phlebitis, the diagnosis is obvious although sometimes unrecognized, and the current consensus is to use anticoagulants: heparin followed by anti-vitamin K. From a medico-legal standpoint, stress phlebitis of the upper extremity is not considered a professional disease, but if it is possible to attribute it to a type of work requiring frequent upward positioning of the arms, there is an obligation for these patients to be rehabilitated professionally.
上肢压力性静脉炎实际上是由于在某些动作过程中锁骨下静脉在肋锁间隙受到压迫所致，用力只是一个偶然因素。临床上，它分两个阶段发展：在间歇性压迫阶段，功能症状与上肢的某些姿势有关；临床上通过体格检查及其他检查来确定压迫情况。治疗包括物理治疗；然而，症状持续可能不得不考虑切除第一肋。在机化性静脉炎阶段，诊断虽有时未被认识到但很明显，目前的共识是使用抗凝剂：先使用肝素，然后使用维生素K拮抗剂。从法医学角度来看，上肢压力性静脉炎不被视为职业病，但如果有可能将其归因于一类需要频繁将手臂向上摆放的工作类型，那么有义务对这些患者进行职业康复治疗。
