Roberts J R
JACEP. 1977 Jan;6(1):16-20. doi: 10.1016/s0361-1124(77)80280-3.
Five infants with hypocalcemia experienced complications after treatment with calcium gluconate intravenously. Inadvertent soft tissue extravasation resulted in erythema, subcutaneous calcification, tissue necrosis, skin slough, and transient radial nerve damage with wrist drop, the latter previously unreported. The soft tissue lesions may be mistaken for cellulitis, abscess, calcified hematoma, or osteomyelitis, resulting in unnecessary antibiotic therapy or surgical intervention. Initially, no clinical abnormality may be apparent. The lesions appear from days to weeks following extravasation. Radiographs are initially negative but soft calcification appears in one to three weeks. Follow-up x-ray films show complete resorption of the calcium over several months. Skin sloughs heal in four to six weeks without skin grafting. Extreme care in the parenteral use of calcium gluconate and conservative treatment of the complications is advocated.
五名低钙血症婴儿在静脉注射葡萄糖酸钙治疗后出现并发症。意外的软组织外渗导致红斑、皮下钙化、组织坏死、皮肤脱落以及伴有垂腕的短暂性桡神经损伤，后者此前未见报道。软组织病变可能被误诊为蜂窝织炎、脓肿、钙化性血肿或骨髓炎，从而导致不必要的抗生素治疗或手术干预。起初，可能没有明显的临床异常。病变在外渗后数天至数周出现。X线片最初为阴性，但在一至三周内出现软组织钙化。随访X线片显示钙在数月内完全吸收。皮肤脱落在四至六周内愈合，无需植皮。提倡在胃肠外使用葡萄糖酸钙时格外小心，并对并发症进行保守治疗。
