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妇科手术后的盆腔神经损伤:一项前瞻性队列研究。

Pelvic nerve injury following gynecologic surgery: a prospective cohort study.

作者信息

Bohrer Justin C, Walters Mark D, Park Amy, Polston David, Barber Matthew D

机构信息

Women's Health Institute of the Cleveland Clinic, Cleveland, OH, USA.

出版信息

Am J Obstet Gynecol. 2009 Nov;201(5):531.e1-7. doi: 10.1016/j.ajog.2009.07.023. Epub 2009 Sep 17.

Abstract

OBJECTIVE

The purpose of this study was to determine the incidence and time course of postoperative neuropathy resulting from gynecologic surgery.

STUDY DESIGN

A single cohort of 616 female patients undergoing elective gynecologic surgery for benign or malignant conditions at a tertiary care academic medical center underwent a postoperative neurologic evaluation to identify postoperative neuropathy of the lower extremities.

RESULTS

Fourteen peripheral nerve injuries were observed in 11 patients, making the overall incidence of postoperative neuropathy 1.8% (95% confidence interval, 1.0-3.2). Injury to the lateral femoral cutaneous (5), femoral (5), common fibular (1), ilioinguinal/iliohypogastric (1), saphenous (1), and genitofemoral (1) nerves were detected. Complete resolution of neuropathic symptoms occurred in all but 1 patient (91%). Median time to resolution of symptoms was 31.5 days (range, 1 day to 6 months).

CONCLUSION

The incidence of lower extremity neuropathy attributable to gynecologic operations is low, and these neuropathies resolve in the great majority of cases.

摘要

目的

本研究旨在确定妇科手术导致的术后神经病变的发生率和病程。

研究设计

在一家三级医疗学术医学中心,对616例因良性或恶性疾病接受择期妇科手术的女性患者进行了单队列研究,术后进行神经学评估以确定下肢术后神经病变。

结果

在11例患者中观察到14例周围神经损伤,术后神经病变的总体发生率为1.8%(95%置信区间,1.0 - 3.2)。检测到股外侧皮神经(5例)、股神经(5例)、腓总神经(1例)、髂腹股沟/髂腹下神经(1例)、隐神经(1例)和生殖股神经(1例)损伤。除1例患者外,所有患者的神经病变症状均完全缓解(91%)。症状缓解的中位时间为31.5天(范围,1天至6个月)。

结论

妇科手术所致下肢神经病变的发生率较低,且大多数病例的这些神经病变可缓解。

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