Janoff K A, Phinney E S, Porter J M
Am J Surg. 1985 Jul;150(1):147-52. doi: 10.1016/0002-9610(85)90024-8.
Ten patients, 8 female and 2 male, with refractory episodic lower extremity vasospasm were encountered during a 15 year period in which over 600 patients with upper extremity vasospasm were studied. Seven patients had associated upper extremity vasospasm. No patient had evidence of autoimmune disease. Lower extremity reserpine Bier block produced symptomatic relief for 1 to 3 days in all patients in whom it was used. Oral medications were ineffectual. A diagnostic toe photoplethysmographic pattern was noted in these patients, consisting of a normally pulsatile tracing after warming and a flat, nonpulsatile or minimally pulsatile tracing after cooling. Each patient underwent lumbar sympathectomy. During follow-up, which averaged 4 years, each patient remained free of episodic vasospasm on the side of surgery. We conclude that lumbar sympathectomy is an effective and durable treatment for lower extremity vasospasm.
在15年期间，我们研究了600多名上肢血管痉挛患者，其中遇到了10例难治性发作性下肢血管痉挛患者，8例女性，2例男性。7例患者伴有上肢血管痉挛。没有患者有自身免疫性疾病的证据。下肢利血平比尔阻滞在所有使用该方法的患者中都产生了1至3天的症状缓解。口服药物无效。在这些患者中观察到一种诊断性的趾光电容积描记图模式，包括 warming 后正常的搏动性描记和 cooling 后平坦、无搏动或最小搏动性描记。每位患者都接受了腰交感神经切除术。在平均4年的随访期间，每位患者手术侧均未再出现发作性血管痉挛。我们得出结论，腰交感神经切除术是治疗下肢血管痉挛的一种有效且持久的方法。
