Shukla P C
Division of Emergency Medicine, University of Mississippi Medical Center, Jackson, USA.
J Emerg Med. 1995 Jan-Feb;13(1):65-70. doi: 10.1016/0736-4679(94)00124-3.
Acute ischemia of the hand following intra-arterial injection of a drug is an infrequent problem, but it requires urgent medical attention. In this report, a patient injected a nasal decongestant, oxymetazoline hydrochloride (Afrin), into his radial artery. This resulted in severe burning pain, and cyanotic, cold, and pulseless hand, suggestive of acute ischemia. Intra-arterial papaverine, nifedipine, anticoagulation with heparin, prednisone, and stellate ganglion block did not improve the hand circulation. Development of gangrene necessitated a disarticulation at the wrist joint. Diagnosis, complications, and therapeutic measures of acute hand ischemia secondary to intra-arterial drug injection are discussed.
动脉内注射药物后手部急性缺血是一个罕见的问题，但需要紧急医疗处理。在本报告中，一名患者将一种鼻减充血剂盐酸羟甲唑啉（阿弗林）注入其桡动脉。这导致了严重的灼痛，手部出现青紫、冰冷且无脉搏，提示急性缺血。动脉内注射罂粟碱、硝苯地平、肝素抗凝、泼尼松以及星状神经节阻滞均未能改善手部血液循环。坏疽的发展使得必须进行腕关节离断术。本文讨论了动脉内药物注射继发急性手部缺血的诊断、并发症及治疗措施。
