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[重症监护患者长期卧床后腓总神经麻痹]

[Peroneal nerve paresis after long-term bed rest in intensive care patients].

作者信息

Wiis J, Qvist J

机构信息

H:S Rigshospitalet, RHIMA-Centret, epidemiafdeling M.

出版信息

Ugeskr Laeger. 1999 Aug 16;161(33):4641-2.

Abstract

Despite careful nursing and physiotherapy, wasting, myopathy and neuropathy are commonly seen in sedated or comatose intensive care patients undergoing long term bedrest. Four cases of peroneal nerve lesion with drop-foot are described in patients with up to eight weeks of immobilisation due to severe infections complicated with multiple organ failure. No other peripheral nerve compression syndromes were found. These isolated nerve lesions could not be related to the metabolic or cerebral status of the patients. To avoid rotation of the hipjoints with secondary muscle contracture the nursing procedure in the ICU had been changed shortly before the incidents of drop-foot were detected. Along with well-known prophylactic anti-compression procedures, sandbags were now placed on the lateral side of the knees. After abandoning this new procedure, peroneal nerve lesions have not been seen.

摘要

尽管进行了精心护理和物理治疗,但在接受长期卧床的镇静或昏迷重症监护患者中,消瘦、肌病和神经病变仍很常见。本文描述了4例因严重感染并发多器官衰竭而固定长达8周的患者出现的腓总神经损伤伴足下垂。未发现其他周围神经压迫综合征。这些孤立的神经病变与患者的代谢或脑部状况无关。为避免髋关节旋转继发肌肉挛缩,在检测到足下垂事件前不久,重症监护病房(ICU)的护理程序已更改。除了众所周知的预防性抗压迫措施外,现在在膝盖外侧放置沙袋。放弃这一新程序后,未再出现腓总神经损伤。

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