Hachulla E, Hatron P Y, Devulder B
Service de Médecine Interne, Hôpital Claude Huriez, Lille.
Rev Med Interne. 1993 May;14(5):329-39. doi: 10.1016/s0248-8663(05)81311-6.
Arteriopathies of occupational diseases predominate in the upper limbs and are usually expressed as Raynaud's phenomenon ("white finger"), sometimes complicated by digital gangrene. Hand-arm vibration disease, hypothenar hammer syndrome, exposure to silica even without silicosis and vinyl chloride intoxication are the principal causes of occupational diseases acknowledged as such by the laws. In a personal series of 60 patients with complicated upper limb arteriopathies, 25% had a recognized occupational disease. Since December 1992, Erasmus' syndrome and systemic scleroderma due to silica without silicosis have been accepted in France as being occupational diseases. The therapeutic problems are discussed, notably the surgical indications in hypothenar hammer syndrome, the possible medical treatments of finger necrosis occurring in Erasmus' syndrome and, in particular, the role played by spinal cord neurostimulation.
职业病性动脉病以上肢为主，通常表现为雷诺现象（“白指”），有时并发指端坏疽。手臂振动病、小鱼际锤状指综合征、即使无矽肺的二氧化硅接触以及氯乙烯中毒是法律认可的此类职业病的主要病因。在一组60例复杂上肢动脉病患者中，25%患有确诊的职业病。自1992年12月起，法国已将伊拉斯谟综合征和无矽肺的二氧化硅所致系统性硬化症认定为职业病。文中讨论了治疗问题，特别是小鱼际锤状指综合征的手术指征、伊拉斯谟综合征中手指坏死可能的药物治疗，尤其是脊髓神经刺激所起的作用。
