鎖骨下動脈盜移症候群－病例報告

鎖骨下動脈盜移症候群（Subclavian steal syndrome）患者並不少見。然其發生率和罹病率至今各學者報告不一，主要是臨床症狀不明顯。本文報告一位64歲男性患者，因難以忍受的左手臂酸麻無力和頭暈而住院。患者在地方診所已知兩手臂血壓差鉅大長達半年；同時左手臂酸麻感和頭暈症狀會因甩手動作而加重。理學檢查顯示兩上臂收縮壓差遠40 mmHg，左手橈動脈脈動有明顯減弱和遲延現象。進一步檢查包括頭部超音波血流探測術、分段血壓測量、分段脈量記錄儀（segmental pulse volume record）和主動脈弓血管攝影（aortic angiogram）得以確立診斷。文獻報告，此症近十年來的治療方法，已由早期單純結紮、動脈內膜切除術或分流手術，發展至較簡易的經皮穿腔血管整形術（percutaneous transluminal angioplasty）。由於隨時有腦中風發作的潛在危機，及早的治療實具預防功效。然此診斷常為臨床醫師所疏忽，故特提出報告和討論，以供參考。

關鍵字

鎖骨下動脈盜移症候群；分段脈量記錄儀；主動脈弓血管攝影；經皮穿腔血管整型術

並列摘要

Subclavian steal syndrome is caused by a stenotic or occulsive lesion in the proximal subclaian or innominate artery. The incidence and prevalence is unknown. Atherosclerosis is the usual underlying etiology. Aortic arch angiography is the one of best diagnostic tool. Percutaneous transluminal angioplasty is considered the first choice for treating this syndrome, because it is simple and safe. If it fails, surgical reconstruction is then considered. We hereby report a case of subclavian steal syndrome, admitted due to dizziness, paresthesia of left arm and a over 40 mmHg difference of systolic blood pressure between the right and left arms for six months. The dignosis involved history, clinical manifestation, physical examination, segmental blood pressure evaluation, ultrasonic doppler detection, segmental pulse volume recording and aortic angiography. The definite diagnosis was proven by aortic angiography. A discussion and review of literature are presented in order to provide clinical reference in the future.

並列關鍵字

Subclavian steal syndrome ； Segmental pulse volume recorder ； Aortic angiogram ； Percutaneous transluminal angioplasty

國際替代計量

鎖骨下動脈盜移症候群－病例報告

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