CAJ | 학술논문

作为最重要的呼吸肌,膈肌功能的监测对危重症尤其是机械通气的患者非常重要,能否成功撤机与膈肌功能状态密切相关.近年来,临床医师对危重症患者的呼吸肌功能障碍越来越重视,而最大吸气负压等传统评估膈肌力量的方法受制于患者主观努力和配合程度的影响,可信度和重复性不好,因此,需要一种有效的客观评估方法来评估患者的膈肌功能.目前用于客观评估膈肌功能的方法很少,膈神经磁刺激技术是其中之一.本文主要介绍膈神经磁刺激评估膈肌功能的方法及其在ICU的应用前景.
작위최중요적호흡기,격기공능적감측대위중증우기시궤계통기적환자비상중요,능부성공철궤여격기공능상태밀절상관.근년래,림상의사대위중증환자적호흡기공능장애월래월중시,이최대흡기부압등전통평고격기역량적방법수제우환자주관노력화배합정도적영향,가신도화중복성불호,인차,수요일충유효적객관평고방법래평고환자적격기공능.목전용우객관평고격기공능적방법흔소,격신경자자격기술시기중지일.본문주요개소격신경자자격평고격기공능적방법급기재ICU적응용전경.
Diaphragm is the most important respiratory muscle.Accurate monitory of diaphragm function is pivotal for the treatment of critically ill patients,especially to those receiving mechanical ventilation,as their needs of mechanical ventilation heavily depend on diaphragm functions.Clinicians have recently paid more and more attentions to respiratory muscle dysfunction in critically ill patients.However,the traditional diaphragm strength measurement based on the maximal respiratory pressure is restricted by patient' s volition and willing to collaborate,with unsatisfied reliability and repeatability.Therefore,a simple,effective and objective method to evaluate diaphragm function is in urgent need.Currently,those methods are very limited,and magnetic phrenic nerve stimulation technology is emerging as an important one.In this paper we will review this method and its potential application in the intensive care unit.