Devin R, Branchereau A, Bordeaux J, Bourgoin M C
Phlebologie. 1985 Oct-Dec;38(4):569-74.
Classically, the primary forms of phlebitis of the upper limb due to venous compression in the thoracic outlet have been radically contrasted with the secondary phlebitis, always iatrogenic, occurring after peripheral venipuncture. However, this distinction is perhaps not as clear as all that. In this paper, the authors report 3 cases of iatrogenic phlebitis of the upper limb. In all 3 cases, phlebography demonstrated venous compression at the thoracic outlet. Consequently, the development of phlebitis in the upper limb after a nervous puncture should always suggest the possibility of a thoracic outlet syndrome and is an indication for phlebography. Conversely, a corollary to the diagnosis of thoracic outlet syndrome should be the formal contraindication of intravenous infusion on the affected side. The treatment of these iatrogenic forms of phlebitis involves the use of anticoagulants followed by surgical resection of the 1st rib to decompress the collateral venous circulation.
传统上，因胸廓出口处静脉受压导致的上肢静脉炎的主要形式与继发于外周静脉穿刺、且总是医源性的继发性静脉炎形成了鲜明对比。然而，这种区分可能并非如此清晰。在本文中，作者报告了3例上肢医源性静脉炎病例。在所有3例病例中，静脉造影显示胸廓出口处静脉受压。因此，神经穿刺后上肢静脉炎的发生应始终提示胸廓出口综合征的可能性，并且是静脉造影的指征。相反，胸廓出口综合征诊断的一个必然结果应该是患侧静脉输注的正式禁忌。这些医源性静脉炎形式的治疗包括使用抗凝剂，随后手术切除第一肋骨以减压侧支静脉循环。
