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一次误行的肌肉注射与危及肢体的缺血。

A misplaced intramuscular injection and limb-threatening ischemia.

作者信息

Sarkar Sumantra, Misra Sarbani, Nandi Madhumita, Mondal Rakesh

机构信息

Department of Pediatric Medicine, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, West Bengal, India.

Department of Pediatric Medicine, NRS Medical College, Kolkata, West Bengal, India.

出版信息

J Family Med Prim Care. 2017 Jul-Sep;6(3):680-682. doi: 10.4103/2249-4863.222058.

DOI:10.4103/2249-4863.222058
PMID:29417035
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5787982/
Abstract

Femoral artery thrombosis is a rare complication of intramuscular (IM) injection in children. A 12-month-old boy presented with right lower limb ischemia and digital gangrene 3 days after an injection of ceftriaxone administered to his medial aspect of the right thigh. Successful thrombolysis and partial limb salvage was possible with enoxaparin despite a late presentation. Unnecessary and unsafe IM injection in community practice might lead to such devastating outcome which should be avoided.

摘要

股动脉血栓形成是儿童肌肉注射罕见的并发症。一名12个月大的男孩在右大腿内侧注射头孢曲松3天后出现右下肢缺血和手指坏疽。尽管就诊较晚，但使用依诺肝素成功进行了溶栓并部分挽救了肢体。社区医疗中不必要且不安全的肌肉注射可能导致这种灾难性后果，应予以避免。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/aa0da01e4829/JFMPC-6-680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/f6c9c11fb87a/JFMPC-6-680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/754ac6353bef/JFMPC-6-680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/aa0da01e4829/JFMPC-6-680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/f6c9c11fb87a/JFMPC-6-680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/754ac6353bef/JFMPC-6-680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e2/5787982/aa0da01e4829/JFMPC-6-680-g003.jpg

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本文引用的文献

1
Successful thrombolysis following enoxaparin therapy in two pediatric patients with congenital heart disease presenting with intracardiac and cerebral thrombosis.两例先天性心脏病患儿在接受依诺肝素治疗后成功溶栓，表现为心内和脑血栓形成。
Thromb J. 2014 Sep 9;12:19. doi: 10.1186/1477-9560-12-19. eCollection 2014.
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Upper limb gangrene following intramuscular diclofenac: a rare side effect.肌肉注射双氯芬酸后出现上肢坏疽：一种罕见的副作用。
J Surg Case Rep. 2013 Feb 15;2013(2):rjs039. doi: 10.1093/jscr/rjs039.
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Nicolau syndrome after intramuscular injection: 3 cases.
肌肉注射后发生的尼科劳综合征：3例报告
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Gangrene after penicillin injection (a case report).青霉素注射后坏疽（一例报告）。
Turk J Pediatr. 1995 Jan-Mar;37(1):67-71.
8
Gangrene of the foot following intramuscular injection in the lateral thigh: a case report with recommendations for prevention.大腿外侧肌肉注射后足部坏疽：一例病例报告及预防建议
J Pediatr. 1967 Jan;70(1):110-4. doi: 10.1016/s0022-3476(67)80173-2.
9
Gangrene following intra-arterial injection of procaine penicillin.动脉内注射普鲁卡因青霉素后发生坏疽。
Aust N Z J Med. 1976 Feb;6(1):71-3. doi: 10.1111/j.1445-5994.1976.tb03295.x.