自体动静脉内瘘(autogenous arteriovenous fistula,AVF)血栓形成是血液透析患者内瘘失功的常见病因。手法按摩因简单便捷被用于AVF血栓的紧急处理,但其可导致感染、栓子脱落等并发症,甚至危及生命。河北医科大学第一医院肾内二科收治1例AVF血栓形成后,因手法按摩致肢端动脉菌栓播散,合并多发转移性脓肿的患者,临床罕见,特为报道。
Autogenous arteriovenous fistula (AVF) thrombosis is a common cause of fistula failure in hemodialysis patients. Manual massage is used for emergency treatment of AVF thrombosis due to its simplicity and convenience, but it can lead to complications such as infection, and thrombus detachment, and even endanger lives. We have treated one case with AVF thrombosis. The bacterial emboli in the limb artery were disseminated due to manual massage, accompanied by multiple metastatic abscesses. This is a rare clinical case we reported here.
[1]Siu LK, Yeh KM, Lin JC, et al.Klebsiella pneumoniae liver abscess:a new invasive syndrome Lancet Infect Dis[J].Lancet Infect Dis.[J]., 2012, 12(11):881-887
[2]Shah A, Ansari N, Hamadeh Z.Cardiac arrest secondary to bilateral pulmonary emboli following arterovenous fistula thrombectomy:a case report with reviewof the literature[J].Case Reports in Nephrology,[J]., 2012, :831726-831726
[3]Pinard EA, Fazal S, Schussler JM.atastrophic paradoxical embolus after hemodialysis access thrombectomy in a patient with a patent foramen ovale[J].Int Urol Nephrol,[J]., 2013, 45(4):1215-1217
[4]M.Delgado CórdovaAcute ischaemia as a consequence of arteriovenous fistula massage in haemodialysis [J].[J].Nefrologia, 2009, 29.(4):367-8
[5]Shrestha BM.Massaging thrombosed PTFE hemodialysis access graft: recipe for disaster [J].[J].J Vasc Access, 2007, 8(4):120-2
[6]陈灿,王凯乐,黄细莲,等.肺炎克雷伯菌感染致对称性外周性坏疽一例并文献复习 [J].[J].中华临床感染病杂志, 2017, 10(4):281-284
[7]Lee CR, Lee JH, Park KS, et al.Antimicrobial Resistance of Hypervirulent Klebsiella pneumoniae:Epidemiology, Hypervirulence-Associated Determinants, and Resistance Mechanisms[J].[J]., 2017, 7: 483- 483
[8]Liu YC, Cheng DL, Lin CL.Klebsiella pneumoniae liver abscess associated with septic endophthalmitis [J].[J].Arch Intern Med, 1986, 146(10):1913-1916
[9]Russo TA, Marr CM.Hypervirulent Klebsiella pneumoniae[J].[J]., 2019, 32(3):1098-6618
[10]叶李铭,麦丽婷,黄静.高毒力肺炎克雷伯杆菌的临床特征和高毒力机制 [J].[J].国际呼吸杂志, 2017, 37(3):221-226
[11]Lok CE, Huber TS, Lee T, et al.KDOQI clinical practice guideline for vascular access:2019 update [J].[J].Am J Kidney Dis, 2020, 75(4):S1-S164
[12]Panagiotis Kitrou, Marios Papasotiriou, et al.Recent developments in endovascular interventions to sustain vascular access patency in haemodialysis patients [J].[J].Nephrol Dial Transplant, 2019, 34(12):1994-2001
[13]Lin Ruan, Yanli Yang, Guangwei Ren, et al.Scoop thrombectomy:A declotting technique for the treatment of thrombosed autologous arteriovenous fistula.A single-center retrospective study [J]., 2022, 17(10):e0276067-e0276067