Mrsić Viviana, Rasić Zarko, Velnić Davorin, Adam Visnja Nesek, Stojcić Elvira Grizelj, Smiljanić Aleksandra
University Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia.
Acta Med Croatica. 2011 Dec;65(5):435-44.
Acute compartment syndrome of the muscle is condition in which prolonged increase of tissue pressure in closed unyelding fascial compartments reduces capillary perfusion below a level necessary for tissue viability leading to muscle and nerve ischaemia for few hours. There are wide variety different clinical settings associated with compartment syndrome. Acute lower limb compartment syndrome that occur during and after prolonged surgical procedures in Lloyd Davies position is rare but potentially devastating complication that can lead serious local complications and life threatening situations as, rabdomyolysis, kidney failure and death. In this article we summarize pathophysiology, clinical staging and diagnostic procedures of acute compartment syndrome in Lloyd Davies position. We present female patient developed limb compartment sindrome after surgical procedure which lasted 6,5 hours in the Lloyd Davies position for extensive rectovaginal endometriosis. In this article we rewiev different contributing factors that may predispose to compartment syndrome during Lloyd Davies position and undescore importance of recognise the risk factor and prevent the esthablishment of acute compartment syndrome during and after surgery in the Lloyd Davies position.
肌肉急性骨筋膜室综合征是一种因封闭且坚韧的筋膜室内组织压力持续升高,导致毛细血管灌注降至组织存活所需水平以下,进而引发肌肉和神经缺血数小时的病症。骨筋膜室综合征存在多种不同的临床情况。在劳埃德·戴维斯体位下长时间手术过程中及术后发生的急性下肢骨筋膜室综合征虽罕见,但却是一种潜在的毁灭性并发症,可导致严重的局部并发症以及危及生命的情况,如横纹肌溶解、肾衰竭和死亡。在本文中,我们总结了劳埃德·戴维斯体位下急性骨筋膜室综合征的病理生理学、临床分期和诊断方法。我们介绍了一名女性患者,她因广泛的直肠阴道子宫内膜异位症在劳埃德·戴维斯体位下进行了长达6.5小时的手术后发生了肢体骨筋膜室综合征。在本文中,我们回顾了在劳埃德·戴维斯体位期间可能易引发骨筋膜室综合征的不同促成因素,并强调了识别风险因素以及在劳埃德·戴维斯体位手术期间及术后预防急性骨筋膜室综合征发生的重要性。