Arteriovenous fistula and pseudoaneurysm –
Also known as arteriovenous fistula arteriovenous aneurysm, arteries and veins are present between the abnormal channel . Acquired arteriovenous fistula, often caused by penetrating injury . Acupuncture is one of the causes improper . Pseudoaneurysm , here is the acupuncture damage artery walls , traumatic pseudoaneurysm caused . Unexpected in this regard from the seventies of the last century the number of cases have been reported so far , although not much, but because of the event, to be surgery, it should pay attention to.
[ Reason ] injury
First, acupuncture causes; arteriovenous fistula due to improper Hegu acupuncture . Because there Hoku hand vein network, the beginning part of the cephalic vein , radial vein from a point just proximal to the palm of the back office wear , compared superficial , so the selection of points allowed or piercing too deep can cause arteriovenous penetrating injury occurs , large or small hematoma , but most of the blood from the artery through the fistula , points into the proximal veins. Machine process hematoma , under the influence of arteriovenous pressure difference can be formed in a through arteries and veins between the sac or tumor. Pseudoaneurysm , more common in the important artery near points, such as the common carotid artery around Futu , Tianding , skylights, water inrush and other points . In addition , there are also a result of deep puncture caused by improper zusanli traumatic aneurysm .
Second, the needle reasons: more generally due to the use of thicker needles, such as coarse needles, especially smaller needle tip , such as needles and needles and so on. Such needles easily hurt because the blood vessels ; Secondly , the needle body curved , hooked needle tip , but also vulnerable and blood vessels.
Third, the operation Cause: anatomy, acupuncture or do not understand the point of the injection zone does not know how to avoid blood vessels , chaotic trouble thorns.
Clinical manifestations
An arteriovenous fistula: a multi- trauma after a few weeks or even a few days after emergence , limb swelling , pain, numbness, weakness and motor dysfunction . There are obvious signs of superficial varicose veins , skin pigmentation or accompanied by limb ulcers, can occur even gangrene . In the fistula site, generally no mass, palpable was obvious persistent tremor. Persistent “machine rumble ” noise when auscultation , during systole enhance and propagate along the proximal and distal blood .
Second, traumatic pseudoaneurysm : in deep puncture occurred after the puncture site in ( or near their deep ) a pulsatile mass , and gradually increasing , local tenderness, there may be serious dysfunction, such as neck , may have difficulty swallowing , respiratory distress . Auscultation and murmur could be heard . In addition , arterial caused lithography , to ascertain the origin of the aneurysm , compensatory collateral circulation in case there is some state help .
[ Prevention ]
First, an important artery in the vicinity of Hegu acupuncture point , we must grasp the anatomy , try to avoid blood vessels. In particular, to prevent the same vein damage .
Second, avoid using a needle , do not use non- needle acupuncture needles and other tools. Injection, the needle should not be too deep , chaotic mention Framing , the first injection should withdraw blood.
Third, if there is signs of bleeding should be promptly treated .
[ Approach ]
When they find there is bleeding , mild clinical symptoms when cold should also be bandaged , and closely observe . Such as bleeding, the diagnosis has been determined , it shall surgery. And symptomatic treatment.