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COVID-19大流行期间重症监护环境中的单侧压迫性腓总神经病变:三例系列报道

Unilateral Compressive Peroneal Neuropathy in Intensive Care Settings During the COVID-19 Pandemic: A Series of Three Cases.

作者信息

Andiappan Kavitha, Nyein Yin Khin, Zainudin Muhamad Faizal

机构信息

Department of Rehabilitation Medicine, Hospital Sungai Buloh, Sungai Buloh, MYS.

Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, MYS.

出版信息

Cureus. 2024 Jul 30;16(7):e65789. doi: 10.7759/cureus.65789. eCollection 2024 Jul.

Abstract

Peroneal nerve entrapment, typically associated with behaviors like cross-legged sitting or squatting, can also occur from extended periods of lying down where the lower limbs usually assume a position of hip external rotation and knee flexion. In such positions, the fibular head's prominence can exert sustained pressure on the peroneal nerve. We report three cases of unilateral peroneal neuropathy in intensive care unit (ICU) patients during the coronavirus disease (COVID-19) pandemic, highlighting the possible role of prolonged supine or lateral decubitus positions in the development of this condition. Electrophysiological studies confirmed peroneal nerve palsy in all cases, with two patients achieving full recovery, while the third required a permanent ankle foot orthosis for mobility due to a lack of neurological recovery. The COVID-19 pandemic has challenged ideal nursing care, including in ICU settings, leading to suboptimal nursing care standards and compromised frequent positioning regimes.

摘要

腓总神经卡压通常与盘腿坐或蹲姿等行为有关,长时间躺下时也可能发生,下肢通常处于髋关节外旋和膝关节屈曲的位置。在这种姿势下,腓骨头的突出可能会持续压迫腓总神经。我们报告了3例在冠状病毒病(COVID-19)大流行期间重症监护病房(ICU)患者发生单侧腓总神经病变的病例,强调了长时间仰卧或侧卧位在该病发生过程中可能起的作用。电生理研究证实所有病例均存在腓总神经麻痹,2例患者完全康复,而第3例患者因神经功能未恢复,需要使用永久性踝足矫形器来辅助行动。COVID-19大流行对理想的护理工作提出了挑战,包括在ICU环境中,导致护理标准不理想,频繁的体位调整方案也受到影响。

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