Williams M E
Beth Israel Deaconess Hospital, Boston, Mass., USA.
Am J Nephrol. 1998;18(6):562-4. doi: 10.1159/000013409.
Hemodialysis-associated subclavian venous stenosis should be suspected when upper extremity edema occurs after a graft or fistula has been placed there. Alternatively, venous thoracic outlet syndrome could also produce venous congestion, simulating subclavian stenosis. The latter diagnosis was unsuspected until central subclavian vein obstruction on venography became complete, with the arm passively hyperabducted. The patient's symptoms resolved after surgical decompression. Causes of thoracic outlet obstruction are reviewed.
当在上肢植入移植物或动静脉内瘘后出现上肢水肿时,应怀疑存在血液透析相关的锁骨下静脉狭窄。另外,胸廓出口静脉综合征也可导致静脉淤血,类似于锁骨下静脉狭窄。在静脉造影显示锁骨下静脉中央梗阻完全形成且手臂被动过度外展之前,一直未怀疑到后者的诊断。手术减压后患者症状缓解。本文对胸廓出口梗阻的病因进行了综述。