CAJ | 학술논문

目的分析先天性心脏手术后膈肌麻痹的临床表现,探讨其诊断及手术时机.方法 2007年1月至2011年7月,共有51例诊断为先心病术后膈肌麻痹,其中22例行膈肌折叠术,3例死亡.结果膈肌麻痹患儿的术后住院时间多于无膈肌麻痹的患儿(38.7d±20.1 d比12.1d±11.3d,P＜0.001).膈肌麻痹患儿的年龄小于无膈肌麻痹的患儿(P＜0.001).行膈肌折叠术与未行折叠术患儿的年龄(9.3个月±30.2个月比2.8个月±3.3个月,P=0.254)和体重(6.9 kg±1.7 kg比4.9kg±0.4 kg,P=0.190)无区别.膈肌折叠术后的机械通气时间短于膈肌折叠术前的机械通气时间(3.8d±4.6d比18.0d±2.4d,P＜0.001).结论膈肌麻痹增加术后呼吸系统并发症的发生率,延长术后机械通气时间及术后住院时间.膈肌折叠术有助于膈肌麻痹患儿脱离呼吸机;年龄不是施行膈肌折叠术的决定因素.
목적 분석선천성심장수술후격기마비적림상표현,탐토기진단급수술시궤.방법 2007년1월지2011년7월,공유51례진단위선심병술후격기마비,기중22례행격기절첩술,3례사망.결과 격기마비환인적술후주원시간다우무격기마비적환인(38.7d±20.1 d비12.1d±11.3d,P＜0.001).격기마비환인적년령소우무격기마비적환인(P＜0.001).행격기절첩술여미행절첩술환인적년령(9.3개월±30.2개월비2.8개월±3.3개월,P=0.254)화체중(6.9 kg±1.7 kg비4.9kg±0.4 kg,P=0.190)무구별.격기절첩술후적궤계통기시간단우격기절첩술전적궤계통기시간(3.8d±4.6d비18.0d±2.4d,P＜0.001).결론 격기마비증가술후호흡계통병발증적발생솔,연장술후궤계통기시간급술후주원시간.격기절첩술유조우격기마비환인탈리호흡궤;년령불시시행격기절첩술적결정인소.
Objective To analyze manifestations of diaphragmatic paralysis after surgery for congenital heart diseases,and explore the diagnosis and timing of surgery.Methods From January 2007 to July 2011,51 congenital heart disease patients were diagnosed with diaphragmatic paralysis post-cardiac surgery.22 cases were treated by diaphragm plication.3 cases of these 22 subsequently died.Results Postoperative hospital stay of patients with diaphragmatic paralysis were longer than those without diaphragmatic paralysis patients (P＜0.001).Diaphragm paralysis patients were also younger (P＜0.001).The age and body weight of patients who underwent diaphragmatic plicationwere not different from patients who did not have diaphragmatic plication (P =0.254 & P =0.190).Ventilation time after diaphragmatic plication was shorter than before diaphragmatic plication (P＜0.001).Conclusions Diaphragmatic paralysis impacted patient's respiratory function,increased hospital stay and ventilation time.Diaphragm plication is beneficial for patients to reduce the time spent on the ventilator.Young age is not a prohibitive factor against performing diaphragm plication.