Dean S M, Werman H
Grant Wound Care Center, Grant Hospital, Columbus, OH, USA.
Vasc Med. 1998;3(2):115-20. doi: 10.1177/1358836X9800300205.
A 66-year-old female with diabetes mellitus and end-stage renal disease presented with painful bilateral lower extremity livedo reticularis and necrotic ulcerations. Her distal lower extremity pulses were intact and plethysmographic studies confirmed relatively normal large vessel arterial perfusion. Extensive laboratory analysis was remarkable for an elevated calcium x phosphorous product and parathyroid hormone level. An ulcer biopsy revealed small vessel medial calcinosis, and calciphylaxis was subsequently diagnosed. Despite aggressive wound debridements, antibiotics and subtotal parathyroidectomy, her ulcers failed to improve significantly prompting a trial of hyperbaric oxygen therapy. After 7 weeks of hyperbaric treatments, her ulcers had essentially healed.
一名患有糖尿病和终末期肾病的66岁女性，出现双侧下肢疼痛性网状青斑和坏死性溃疡。她下肢远端脉搏正常，体积描记法研究证实大血管动脉灌注相对正常。广泛的实验室分析显示钙磷乘积和甲状旁腺激素水平升高。溃疡活检显示小血管中层钙化，随后诊断为钙化防御。尽管进行了积极的伤口清创、抗生素治疗和甲状旁腺次全切除术，但她的溃疡仍未明显改善，促使尝试高压氧治疗。经过7周的高压治疗，她的溃疡基本愈合。
