Ali H, Nieto J G, Rhamy R K, Chandarlapaty S K, Vaamonde C A
Medical Service Veterans Affairs Medical Center, Miami, FL 33125.
Am J Kidney Dis. 1993 Dec;22(6):865-9. doi: 10.1016/s0272-6386(12)70347-5.
A patient who developed acute renal failure secondary to rhabdomyolysis associated with the use of the extreme lithotomy position for 6 hours during radical perineal prostatectomy is described. It appears that muscle ischemia due to compression of the lumbar and pelvic muscles resulted in muscle injury. Intense muscle uptake of technetium 99m methylene diphosphonate assisted in localizing the muscles involved and ascertaining the extent of the injury. Review of the literature disclosed seven other patients with a similar association. All patients complained of muscle pain shortly after recovery from anesthesia. Early recognition and aggressive treatment with intravenous fluids may prevent the development of acute renal failure.
本文描述了一名患者，该患者在根治性会阴前列腺切除术期间因极度截石位持续6小时而发生横纹肌溶解继发急性肾衰竭。似乎是由于腰和盆腔肌肉受压导致肌肉缺血，进而造成肌肉损伤。99m锝亚甲基二膦酸盐在肌肉中的强烈摄取有助于确定受累肌肉并明确损伤程度。文献回顾发现了其他7例有类似关联的患者。所有患者在麻醉苏醒后不久均主诉肌肉疼痛。早期识别并积极给予静脉补液治疗可能预防急性肾衰竭的发生。
