Hara Kentaro, Kuroki Tamotsu, Kaneko Shohei, Taniguchi Ken, Fukuda Masashi, Onita Toru, Sawai Terumitsu
National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, Japan 856-8562.
Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan 852-8523.
Surg Open Sci. 2020 Nov 11;3:16-21. doi: 10.1016/j.sopen.2020.10.001. eCollection 2021 Jan.
Compartment syndrome that occurs after lengthy surgery in the lithotomy position is known as well-leg compartment syndrome. It has serious consequences for patients, including amyotrophic renal failure, limb loss, and sometimes even death. This study aimed to identify effective preventive measures against well-leg compartment syndrome using a retrospective cohort study of 1,951 patients (985 and 966 in the prevention and control groups, respectively).
The following preventive interventions were analyzed: (1) changing from the lithotomy position to the open-leg position, (2) removing lower leg pressure caused by the lithotomy position, (3) limiting leg elevation based on the height of the right atrium, (4) horizontally repositioning the operating table every 3 hours, and (5) decompressing the contact area of the lower leg in the lithotomy position during operation.
Eight cases of well-leg compartment syndrome occurred in the control group, whereas no well-leg compartment syndrome occurred in the prevention group.
These findings suggest that the five interventions assessed can prevent the development of well-leg compartment syndrome.
在截石位长时间手术后发生的骨筋膜室综合征称为健侧下肢骨筋膜室综合征。它对患者有严重后果，包括肌萎缩性肾衰竭、肢体丧失，有时甚至死亡。本研究旨在通过对1951例患者（预防组和对照组分别为985例和966例）进行回顾性队列研究，确定预防健侧下肢骨筋膜室综合征的有效措施。
分析以下预防干预措施：（1）从截石位改为开放腿位；（2）消除截石位引起的小腿压力；（3）根据右心房高度限制腿部抬高；（4）每3小时对手术台进行水平重新定位；（5）在手术过程中对截石位小腿的接触区域进行减压。
对照组发生8例健侧下肢骨筋膜室综合征，而预防组未发生健侧下肢骨筋膜室综合征。
这些发现表明，所评估的五项干预措施可预防健侧下肢骨筋膜室综合征的发生。
