- 期刊
Crutch-Induced Axillary/Brachial Artery Injury-Two Case Reports
不當使用枴杖導致之腋下／上臂動脈傷害－二病例報告
摘要
長期使用枴杖導致的急性上肢缺血在臨床上並不多見，然而長期不當使用枴杖可能導致腋下／上臂動脈的狹窄或是動脈瘤的形成。動脈瘤形成可能進一步造成急性血管血栓或遠端血管栓塞。我們報告兩個小兒麻痹的個案，因為長期不當使用枴杖而導致腋下／上臂動脈發生動脈瘤及急性上肢缺血。其中一例以血栓清除術治療，最後仍因漸進性組織壞死而必需行肘關節以下截肢。另一例予以動脈瘤切除後血管修補及血栓清除術，成功的挽救了瀕臨缺血壞死的上肢。為了成功挽救瀕臨缺血壞死的上肢，及時的診斷及正確的手術治療，予以血栓清除術、動脈瘤切除及血管重建是必要的。本篇文章進一步地探討各種治療方式及正確使用枴杖的方式。
關鍵字
無資料並列摘要
Acute ischemia of the upper extremity secondary to chronic crutch use was uncommon. Long term improper usage of the axillary crutches may lead to axillary/brachial artery stenosis or aneurysms formation. Aneurysms formation may be complicated by acute thrombosis or embolization of distal vessels. We reported two postpoliomyelitis patients with crutch-induced axillary/brachial aneurysm complicated with acute upper limb ischemia. One was treated by thromboembolectomy and later unavoidable below-elbow amputation due to progressive gangrenous change of distal limb. The other was treated by both aneurysm resection and thromboembolectomy, and the critical limb was rescued. To salvage an ischemic limb successfully, prompt diagnosis and correct surgical treatment with thromboembolectomy, aneurysm resection and reconstruction is necessary. The roles of treatment modalities and the instructions on correct usage of axillary crutches were discussed.
延伸閱讀
- Liu, H. T., Yu, Y. S., Liu, C. K., Sung, C. S., Chiou, H. J., Tsou, M. Y., & Tsai, S. K. (2005). 接受尺神經置換術病人於施行腋神經阻斷術後發生同側橈神經功能延遲回復的病例報告. Acta Anaesthesiologica Taiwanica, 43(1), 49-53. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200503-43-1-49-53-a
- Lee, P. J., Pan, S. C., Chiu, H. Y., & Lee, Y. C. (2013). 急性創傷閉鎖性槌狀拇指合併伸拇短肌腱傷害誤解為垂落拇指變形─個案報告. 臺灣整形外科醫學會雜誌, 22(2), 133-137. https://www.airitilibrary.com/Article/Detail?DocID=a0000593-201306-201307160050-201307160050-133-137
- 莊垂慶（1991）。臂叢神經傷害的外科治療（二）。當代醫學，(214)，673-675。https://doi.org/10.29941/MT.199108.0012
- 江金隆、鍾進燈、周崇頌、藍顥章（2001）。肩盂肱骨關節脫臼合併腋神經損傷及肩旋轉帶破裂：病例報告暨文獻回顧。中華民國復健醫學會雜誌，29(3)，167-176。https://www.airitilibrary.com/Article/Detail?DocID=10253009-200109-29-3-167-176-a
- 邱涵傑、林永青、王榮俊（2000）。肩半關節置換手術後因牽拉運動引起之植入物旁肱骨幹骨折：病例報告。中華民國復健醫學會雜誌，28(1)，51-55。https://doi.org/10.6315/JRMA.200003.0051