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一个警示信号:新冠肺炎患者的急性肢体缺血

An Alarming Sign: Acute Limb Ischemia in Patients With COVID-19.

作者信息

Mohd Aladin Mohd Faris B, Ramely Rosenelifaizur

机构信息

General Surgery, Raja Perempuan Zainab II Hospital, Kota Bharu, MYS.

Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, MYS.

出版信息

Cureus. 2025 Mar 18;17(3):e80798. doi: 10.7759/cureus.80798. eCollection 2025 Mar.

Abstract

Acute limb ischemia (ALI) can occur as a late complication in patients recovering from COVID-19. Although typically seen during the acute phase, ALI may present weeks to months later, making diagnosis more challenging. Symptoms, including acute limb pain, pallor, coldness, and absent pulses, can be misattributed to other post-viral issues. COVID-19 induces a prothrombotic state that persists after recovery, with increased D-dimer, fibrinogen, and endothelial dysfunction contributing to thrombus formation. Early diagnosis through clinical assessment and imaging is crucial to prevent irreversible limb damage. Treatment involves anticoagulation, revascularization, and supportive care, tailored to the patient's condition. Vigilance for late-onset ALI in post-COVID-19 patients is essential to improve outcomes and prevent limb loss.

摘要

急性肢体缺血(ALI)可能作为新冠肺炎康复患者的晚期并发症出现。虽然通常在急性期出现,但ALI可能在数周或数月后才表现出来,这使得诊断更具挑战性。包括急性肢体疼痛、苍白、发冷和脉搏消失在内的症状,可能会被误诊为其他病毒感染后的问题。新冠肺炎会引发一种血栓前状态,在康复后仍会持续存在,D - 二聚体、纤维蛋白原升高以及内皮功能障碍会导致血栓形成。通过临床评估和影像学进行早期诊断对于预防不可逆的肢体损伤至关重要。治疗包括抗凝、血管再通和支持性护理,需根据患者情况进行调整。对新冠肺炎康复患者中迟发性ALI保持警惕对于改善预后和预防肢体丧失至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35fa/12006679/f41df18f333e/cureus-0017-00000080798-i01.jpg

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