- 期刊
老年鎖骨下竊血症候群病例報告
Subclavian Steal Syndrome: A Case Report
摘要
鎖骨下竊血症候群(subclavian steal syndrome)是鎖骨下動脈近端發生阻塞或有狹窄的情形，導致血液無法順暢地通過同側椎動脈，因而在椎動脈造成逆向的血流，大部分的病人並無不適症狀，但少部分的人會出現如頭暈、暈眩或不平衡等症狀，在進行血壓測量時可以發現兩隻手的上臂血壓差極大，因此可藉由測量兩側上臂血壓作為基本的篩選工具。此案例報告提出一位91歲的高齡長者，抱怨近三個月頭暈和步態不穩，過去病史包括失智與高血壓且長期規律服用降壓藥物治療，此次因步態不穩與跌倒而入院，並於入院檢查發現兩側上臂收縮壓差達50mmHg，血管磁振造影檢查後診斷為左側鎖骨下竊血症候群，而腦血流循環不足的狀況因降血壓藥物使用而惡化，病患於停止降壓藥使用後臨床症狀有明顯的改善。
並列摘要
Patients with subclavian steal syndrome have retrograde blood flow in the vertebral artery associated with proximal ipsilateral subclavian artery stenosis. Most patients are symptomatic while some neurological symptoms such as dizziness, vertigo and imbalance remain uncommon. An obvious difference (on average, 45mmHg) in the brachial systolic blood pressure betweens the patient's bilateral arms may serve as the indicator of the subclavian steal phenomenon. We report a 91-year-old man with dizziness and unsteady gait, diagnosed with hypertension and treated with regular anti-hypertensive agents for several years. His anti-hypertensive agents was stopped after subclavian steal syndrome was found, and his clinical condition reported significant improvement thereafter.
延伸閱讀
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