| 摘 要：背景：局部缺血性盗血综合征是透析时创建动静脉通路的一种合并症，法语毕业论文，虽然很常见并有皮肤表现，但皮肤科医师对本病知之甚少。作者在此报道了1例盗血综合征引起手指局部严重缺血性损伤的男性患者。观察：1例49岁的男性糖尿病患者在动静脉通路形成术后5个月出现左手肢端疼痛综合征，法语论文题目，伴第3指坏死性溃疡。临床检查显示手法压迫漏管后疼痛明显缓解。动脉造影术显示动静脉瘘功能亢进导致末梢灌注压降低，这与盗血综合征的诊断相符合。连接处绷扎法未能使患肢免受截肢。讨论：本病例报道旨在提高皮肤科医师对这种相当常见的动静脉通路形成并发症的警惕。作者讨论了本病的生理病理学、危险度系数、临床特点及疗法。因为盗血综合征的诊断非常直观，所以早期检查很关键。只有适当的手术治疗才可避免坏疽导致的不同程度的截肢范围扩大。Background. Ischemic steal syndrome is a complication of arteriovenous access creation for hemodialysis, and is little known among dermatologists despite the fact is fairly common and has a cutaneous presentation. Herein we report the case of a man presenting with serious ischemic injuries to the fingers associated with steal syndrome. Observation. A 49-year-old diabetic man presented with painful acrosyndrome of the left hand, with a necrotic ulcer on the third finger appearing 5 months after the creation of an arteriovenous access. Clinical examination showed marked pain relief after manual compression of the fistula. Arteriography showed an over functional fistula, causing decreased distal perfusion with the diagnosis of pressure, and this was consistent steal syndrome. Banding of the anastomosis was performed but was insufficient to spare the finger from amputation. Discussion. The aim of our case-report is to increase awareness among dermatologists of this fairly frequent complication of arteriovenous accesses. We discuss the physiopathology, risk factors, clinical features and therapeutic management of this condition. Since diagnosis of steal syndrome is fairly detection is essential. Only adequate can avoid gangrenous manifestations 1 widespread amputation. straightforward, early surgical management eading to more or less |
