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硬膜外浸润在治疗下肢不可手术的急性缺血中的作用(作者译)

[Contribution of epidural infiltration in the treatment of acute ischemia in the lower inoperable limbs (author's transl)].

作者信息

Daniel A M, Dubouis J L, Jolivet F, Barral X, Age B, Motin J

出版信息

Anesth Analg (Paris). 1980;37(7-8):417-21.

PMID:7425323
Abstract

Epidural infiltration easily causes without surgical intervention, paralysis of the sympathetic nervous system and analgesia. In this way, spasm and vasoconstriction are inhibited and the use of collateral vessels which are still permeable is facilitated. The antalgesic position of the dropped foot, which is a cause of oedema and hemodynamic disconfort, is eliminated. Out of 17 patients showing an acute ischemia of the lower limbs treated by this method, seven were cured, 3 of whom already having trophic disorders, 7 underwent local amputations and 3 had leg and thigh level amputations. Six months later 10 of these patients were doing well. The best therapeutic conditions of this treatment are non-atheromatous arteritis: angiospasm, toxic or inflammatory acute ischemia and Buerger's disease. On the other hand, the results are mediocre with atheromatous arteritis.

摘要

硬膜外浸润在无需手术干预的情况下容易导致交感神经系统麻痹和镇痛。通过这种方式,痉挛和血管收缩受到抑制,有利于使用仍具通透性的侧支血管。垂足的镇痛体位得以消除,而垂足是水肿和血流动力学不适的一个原因。在采用这种方法治疗的17例下肢急性缺血患者中,7例治愈,其中3例已有营养障碍,7例行局部截肢,3例行小腿和大腿高位截肢。6个月后,这些患者中有10例情况良好。这种治疗的最佳治疗条件是无动脉粥样硬化性动脉炎:血管痉挛、中毒性或炎性急性缺血以及血栓闭塞性脉管炎。另一方面,对于动脉粥样硬化性动脉炎,治疗结果一般。

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