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目的探讨普鲁卡因加用泼尼松龙局部注射疼痛治疗的血管并发症及原因．方法对收治的11例因应用此种局部注射疼痛治疗导致的肢体缺血患者进行疗效分析,其中6例为上肢缺血,5例为下肢缺血患者。10例患者给予前列地尔(10μg／d)扩张血管、东菱巴曲酶5 U,隔天治疗,首量加倍溶栓,及其他溶栓和活血化淤药物治疗20 d,同时应用高压氧舱治疗2-4个疗程,胫前动脉血栓形成和足背动脉血栓形成的患者急诊手术取栓术,对明显疼痛患者给予镇痛药物对症治疗。结果6例患者经上述治疗后缺血症状完全改善,末梢血运良好,肢体功能恢复,无后遗症,痊愈出院;其中胫前动脉血栓形的患者急诊手术取栓后,血运恢复,足背动脉血栓形成的患者急诊手术取栓后,效果不佳,经药物治疗1例痊愈;2例疼痛明显减轻,皮温增高,但仍存在轻度缺血症状,出院后继续应用抗凝及扩血管药物口服治疗;余3例经治疗后肢体缺血无改善,局部坏疽并感染加重,于1-2个月后截肢。结论普鲁卡因加用泼尼松龙局部注射疼痛治疗可致肢体缺血,应慎用。
Objective To investigate the vascular complications of procaine and prednisolone injection for pain management. Methods The curative effects of 11 patients with limb ischemia caused by local injection of pain were analyzed. Among them, 6 were upper limb ischemia and 5 were lower limb ischemia. Ten patients were treated with alprostadil (10μg / d) dilation of blood vessel, 5 mg of Lingling Batroxobin, every other day, the first double dose of thrombolysis, and other thrombolytic and blood stasis drugs for 20 days, Capsule treatment of 2-4 courses of treatment, anterior tibial artery thrombosis and dorsal artery thrombosis in patients with emergency surgical thrombectomy, the obvious pain in patients given analgesic symptomatic treatment. Results After the above treatment, 6 patients showed complete improvement of ischemic symptoms, good peripheral blood supply, recovery of limb function, and no sequelae. All patients were cured and discharged from the hospital. Among them, patients with anterior tibial artery thrombosis received revascularization after revascularization and dorsal artery Thrombosis patients emergency surgery after thrombectomy, the effect is not good, the drug was cured in 1 case; 2 cases of pain was significantly reduced, skin temperature increased, but there is still mild symptoms of ischemia, continue to use anticoagulants and vasodilator drugs after discharge Oral treatment; more than 3 cases of limb ischemia after treatment without improvement, local gangrene and infection aggravated, amputation in 1-2 months. Conclusion procaine plus prednisolone local injection of pain treatment can cause limb ischemia, should be used with caution.