前言目的探讨心脏直视手术后膈肌麻痹的预防及对策。方法2003年1月 ̄2006年7月我中心在体外循环下共完成心脏直视手术2434例,术后并发膈肌麻痹11例(正中开胸8例,侧开胸3例),均为3岁以下患儿,难于脱离呼吸机,后均经肋间切口行膈肌折叠治疗。结果膈肌折叠术后10例顺利脱离呼吸机,治愈出院,1例死亡(并发肺部感染、呼吸衰竭)。讨论术中良好的膈神经保护可减少心脏直视术后膈肌麻痹的发生,术后早期积极的膈肌折叠治疗可明显地改善患儿的呼吸功能。
ObjectiveToexplorethepreventionandtreatmentofphrenoparalysisafteropen-heartsurgery.MethodsFromJanuary2003toJuly2006,2434casesofopen-heartsurgeryhanbeenperformedundercardiopulmonarybypassinourhospital.Phrenoparalysisoccurredin11patients,including8medianand3lateralsternotomies.Allpatientswerebelowtheageof3yearsandfailedindepartingmechanicalventilation.Diaphragmaticplicationwasperformedviaintercostalsincisions.ResultsTencasessucceededindep...