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[新型冠状病毒肺炎患者在重症监护病房长时间俯卧位后发生股外侧皮神经痛。一例病例报告]

[Meralgia paresthetica after prolonged prone position at the intensive care unit among COVID-19 patients. A case report].

作者信息

Serrano Barrenechea Laura, Nordin Jenny, Sörbo Ann

机构信息

överläkare, neuro- och rehabiliteringskliniken, Södra Älvsborgs sjukhus, Borås.

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出版信息

Lakartidningen. 2021 Feb 3;118:20163.

Abstract

Meralgia paresthetica (MP) is an entrapment syndrome that may cause loss of sensation, numbness, paresthesia and pain within the distribution of the lateral femoral cutaneous nerve. This condition is more common in persons with diabetes mellitus, obesity and in old age. MP has previously been described in patients that have undergone surgery in the prone position (PP) and in a case report of a patient with ARDS (Acute Respiratory Distress Syndrome) who was cared for in the intensive care unit (ICU). Due to the COVID-19 pandemic PP has been widely used for periods of 12-16 hours to improve oxygenation. At the rehabilitation unit at our hospital, we have identified cases of MP in patients with COVID-19 that have required this type of positioning for long periods in the ICU. We would like to draw attention to the fact that there is a risk of peripheral nerve injury in the event of prolonged PP and recommend extra controls, careful positioning and extra padding at the areas where peripheral nerves may be exposed to pressure.

摘要

股外侧皮神经麻痹(MP)是一种卡压综合征,可导致股外侧皮神经分布区域出现感觉丧失、麻木、感觉异常和疼痛。这种情况在糖尿病患者、肥胖者和老年人中更为常见。此前曾在俯卧位手术的患者以及一名在重症监护病房(ICU)接受治疗的急性呼吸窘迫综合征(ARDS)患者的病例报告中描述过MP。由于新冠疫情,俯卧位已被广泛使用12至16小时以改善氧合。在我院康复科,我们发现新冠患者中出现了MP病例,这些患者在ICU中需要长时间采用这种体位。我们想提请注意,长时间采用俯卧位会有外周神经损伤的风险,并建议进行额外检查、仔细摆放体位以及在可能受压的外周神经部位增加衬垫。

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