急性肢体缺血性痉挛：一种罕见的表现。
Acute limb ischaemia due to vasospasm: a rare presentation.
机构信息
Department of Medicine, University of Florida, Gainesville, Florida, USA
Department of Medicine, University of Florida, Gainesville, Florida, USA.
出版信息
BMJ Case Rep. 2022 Jan 6;15(1):e246495. doi: 10.1136/bcr-2021-246495.
A 30-year-old woman with active intravenous drug use presented with pain, blue discolouration, paresthesia and lack of grip strength of left hand for 1 week. Physical examination revealed blue discolouration, decreased sensation and cold to touch in the left hand. She had no palpable radial pulse. She admitted Heroin use only but the urine drug screen was also positive for amphetamine. CT angiogram of the left upper extremity was concerning for acute ischaemia due to arterial occlusion. The initial plan was for amputation. However, to salvage the limb with thrombolysis, an interventional radiology angiogram was performed. The angiogram demonstrated diffuse arterial spasm and response to nitroglycerin. She was treated with nitroglycerin drip and transitioned to a calcium channel blocker. She did improve significantly. To ensure no embolic sequelae, the patient was discharged with a month of oral anticoagulation.
一位 30 岁女性，有静脉注射毒品的活跃史，出现左手疼痛、蓝色变色、感觉异常和握力丧失 1 周。体格检查显示左手蓝色变色、感觉减退和触之发凉。她没有可触及的桡动脉脉搏。她只承认使用了海洛因，但尿液药物筛查也呈安非他命阳性。左上肢 CT 血管造影显示由于动脉闭塞导致急性缺血。最初的计划是截肢。然而，为了通过溶栓来挽救肢体，进行了介入放射学血管造影。血管造影显示弥漫性动脉痉挛和对硝酸甘油的反应。她接受了硝酸甘油滴注治疗，并转为钙通道阻滞剂治疗。她的病情明显改善。为了确保没有栓塞后遗症，患者出院时口服抗凝治疗 1 个月。
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