临床误诊误治2017，Vol.30Issue(7)：21-24,4.DOI:10.3969/j.issn.1002-3429.2017.07.007
胆固醇结晶栓塞误诊原因分析及诊疗建议
Analysis of Misdiagnosed Causes and Diagnosis and Treatment Suggestions of Cholesterol Crystal Embolization
鞠上 1刘宇静 2张晓福 3王刚 1高瑜 3曹欣 3闫程程 3王宁3
作者信息
- 1. 100700 北京,北京中医药大学东直门医院血管外科
- 2. 100700 北京,陆军总医院医学工程科
- 3. 100029 北京,北京中医药大学
- 折叠
摘要
Abstract
Objective To investigate clinical features, misdiagnosed causes and diagnosis and treatment strategy of cholesterol crystal embolization (CCE).Methods Clinical data of 3 misdiagnosed patients with CCE admitted in recent years was retrospectively analyzed.Results The 3 patients with lower limb arteriosclerosis occlusion underwent lower limb intracavity angioplasty treatment, all patients had postoperative lyons blue lesions in toe extremitates skin, and then all patients were misdiagnosed as having blue toe syndrome.Abnormally increased values of renal function level, c-reaction protein (CRP), erythrocyte sedimentation rate and eosinophils were found in 3patients, of whom 2 patients were timely confirmed the diagnosis of CCE, and were forbidden with anticoagulation and thrombolytic therapy, and the prognoses were good by follow-up;1 patient was continuously treated with anticoagulation and thrombolysis, and finally died of multiple organ failure.Conclusion If patients with atherosclerosis have increased eosinophils and inflammatory index levels, skin lesions, unexplained renal injury, gastrointestinal or neurological manifestations after vascular intervention, and CCE should be considered, and therefore histopathologic examination for many times can confirm the diagnosis.关键词
栓塞,胆固醇/动脉粥样硬化/误诊/蓝趾综合征Key words
Embolism/cholesterol/Atherosclerosis/Misdiagnosis/Blue toe syndrome分类
医药卫生引用本文复制引用
鞠上,刘宇静,张晓福,王刚,高瑜,曹欣,闫程程,王宁..胆固醇结晶栓塞误诊原因分析及诊疗建议[J].临床误诊误治,2017,30(7):21-24,4.
