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医源性股神经病变:两例报告及文献综述

Iatrogenic femoral neuropathy: two cases and literature update.

作者信息

Al-Ajmi Abdullah, Rousseff Rossen T, Khuraibet Adnan J

机构信息

Consultant Neurologist, Regional Hospital Farwaniya, Kuwait.

出版信息

J Clin Neuromuscul Dis. 2010 Dec;12(2):66-75. doi: 10.1097/CND.0b013e3181f3dbe7.

Abstract

Iatrogenic femoral neuropathy is an uncommon surgical or obstetric complication that may be underreported. It results from compression, stretch, ischemia, or direct trauma of the nerve during hip arthroplasty, self-retaining retractor use in pelvicoabdominal surgery, lithotomy positioning for anesthesia or labor, and other more rare causes. Decreasing incidence of this complication after abdominal and gynecologic surgery but increase in its absolute numbers after hip arthroplasty has emerged over the last decade. We describe two illustrative cases related respectively to lithotomy positioning and self-retaining retractor use. The variability in clinical presentation of iatrogenic femoral nerve lesions, some new insights in their diverse pathophysiology, and in the diagnostic and treatment options are discussed with an update from the literature.

摘要

医源性股神经病变是一种不常见的手术或产科并发症,可能未得到充分报告。它是由髋关节置换术中神经受压、拉伸、缺血或直接创伤、盆腔腹部手术中使用自持牵开器、麻醉或分娩时的截石位以及其他更罕见的原因引起的。在过去十年中,腹部和妇科手术后这种并发症的发生率有所下降,但髋关节置换术后其绝对数量有所增加。我们描述了分别与截石位和自持牵开器使用相关的两个典型病例。文中结合文献更新内容,讨论了医源性股神经损伤临床表现的变异性、其多样病理生理学的一些新见解以及诊断和治疗选择。

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