Reinstein L, Reed W P, Sadler J H, Baugher W H
Arch Phys Med Rehabil. 1984 Mar;65(3):142-4.
This report presents the first description of direct peripheral nerve compression as a complication of brachial artery-basilic vein vascular access in patients with uremia who are receiving long-term hemodialysis. Three patients are presented. An expanding basilic vein hematoma compressed the radial nerve in one patient. A graft associated abscess adjacent to the brachial artery compressed the median nerve in a second patient. A basilic vein aneurysm compressed the median nerve in a third patient. In two cases, electrodiagnostic studies were helpful in identifying the location and severity of the peripheral nerve dysfunction, and in excluding more common distal nerve dysfunction, which is sometimes seen in these patients as a result of circulatory alterations in the extremity caused by dialysis. Prompt surgical decompression led to significant recovery of nerve function in all three patients. It is concluded that direct peripheral nerve compression is a rare complication of brachial artery-basilic vein vascular access in patients with uremia who are receiving long-term hemodialysis.
本报告首次描述了直接外周神经受压作为接受长期血液透析的尿毒症患者肱动脉-贵要静脉血管通路并发症的情况。报告了3例患者。1例患者中，扩张的贵要静脉血肿压迫桡神经。第2例患者中，肱动脉旁与移植物相关的脓肿压迫正中神经。第3例患者中，贵要静脉瘤压迫正中神经。在2例病例中，电诊断研究有助于确定外周神经功能障碍的部位和严重程度，并排除更常见的远端神经功能障碍，后者有时在这些患者中因透析导致的肢体循环改变而出现。及时的手术减压使所有3例患者的神经功能得到显著恢复。结论是，直接外周神经受压是接受长期血液透析的尿毒症患者肱动脉-贵要静脉血管通路的一种罕见并发症。
