半侧膈肌麻痹：卵圆孔未闭导致右向左分流的一个被低估的病因？
Hemidiaphragmatic paralysis: an underestimated etiology of right-to-left shunt through patent foramen ovale?
作者信息
Darchis Julie S, Ennezat Pierre V, Charbonnel Clément, Aubert Jean Marc, Gonin Xavier, Auffray Jean Luc, Bauchart Jean Jacques, Le Tourneau Thierry, Rey Christian, Godart François, Goldstein Patrick, Asseman Philippe
机构信息
Intensive Care Unit, Cardiology Hospital, Bd Pr J Leclercq, 59000 Lille, France.
出版信息
Eur J Echocardiogr. 2007 Aug;8(4):259-64. doi: 10.1016/j.euje.2006.05.003. Epub 2006 Jul 7.
OBJECTIVE
To report a specific pathophysiology of hemidiaphragmatic paralysis that may result in severe hypoxemia.
DESIGN
Case series.
SETTING
Intensive care unit in a cardiology hospital.
PATIENTS
The series included three patients with refractory hypoxemia in whom a diagnosis of right-to-left-shunt through a patent foramen ovale was made by contrast echocardiography. The three patients had a complete right hemidiaphragmatic paralysis.
INTERVENTION
Permanent percutaneous closure of the patent foramen ovale was successfully proceeded in all cases.
MAIN RESULT
These procedures resulted in complete normalization of arterial oxygen saturation.
CONCLUSION
To our knowledge, only three previous reports have described the association of right-to-left shunt through a patent foramen ovale and hemidiaphragmatic paralysis. Such association may be underestimated.
目的
报告一种可能导致严重低氧血症的半侧膈肌麻痹的特定病理生理学机制。
设计
病例系列。
地点
一家心脏病医院的重症监护病房。
患者
该系列包括三名难治性低氧血症患者，经对比超声心动图诊断为通过卵圆孔未闭存在右向左分流。这三名患者均有完全性右侧半侧膈肌麻痹。
干预措施
所有病例均成功进行了卵圆孔未闭的永久性经皮封堵术。
主要结果
这些手术使动脉血氧饱和度完全恢复正常。
结论
据我们所知，此前仅有三篇报告描述了通过卵圆孔未闭的右向左分流与半侧膈肌麻痹之间的关联。这种关联可能被低估了。
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