与截石位和间歇性加压弹力袜相关的骨筋膜室综合征
Compartment syndrome associated with lithotomy position and intermittent compression stockings.
作者信息
Cohen S A, Hurt W G
机构信息
Department of Obstetrics and Gynecology, Virginia Commonwealth University, Medical College of Virginia Hospitals, PO Box 980034, Richmond, VA 23298-0034, USA.
出版信息
Obstet Gynecol. 2001 May;97(5 Pt 2):832-3. doi: 10.1016/s0029-7844(00)01141-8.
BACKGROUND
Compartment syndrome is a condition in which increased tissue pressure within a limited tissue space compromises the circulation and function of the contents of the space.
CASE
A 43-year-old black woman, para 3, had repair of a recurrent vesicovaginal fistula. She was placed in a low lithotomy position with thigh length sequential compression sleeves. The procedure lasted more than 5 hours. On postoperative day 1, she complained of pain in her right leg and foot. Compartment syndrome was diagnosed and emergency fasciotomy was done.
CONCLUSION
Gynecologists should be aware of the possibility of compartment syndrome during prolonged procedures with patients in the lithotomy position. Concomitant intermittent compression sleeves might further increase the risk. Early diagnosis and treatment of compression syndrome are essential to minimize long-term neurovascular morbidity.
背景
骨筋膜室综合征是一种在有限组织空间内组织压力升高，从而损害该空间内容物的循环和功能的病症。
病例
一名43岁经产3次的黑人女性接受复发性膀胱阴道瘘修补术。她被置于低位截石位，并使用了大腿长度的序贯加压套。手术持续了5个多小时。术后第1天，她抱怨右腿和足部疼痛。诊断为骨筋膜室综合征并进行了急诊筋膜切开术。
结论
妇科医生应意识到在患者处于截石位的长时间手术过程中发生骨筋膜室综合征的可能性。同时使用间歇性加压套可能会进一步增加风险。早期诊断和治疗骨筋膜室综合征对于将长期神经血管并发症降至最低至关重要。
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