Sano Yoshifumi, Oto T, Toyooka S, Yamane M, Okazaki M, Date H
Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Kyobu Geka. 2007 Oct;60(11):993-7.
Phrenic nerve paralysis is a well-documented complication of cardiac operation, but there is less commonly reported after lung transplantation. A retrospective study of 49 lung transplantation was done at Okayama University Hospital. Phrenic nerve paralysis (unilateral in 3 patients and bilateral in 1) was found in 4 patients (8.2%). All of these paralyses were transiently recovered. The average length of ventilation, intensive care unit stay and hospitalization for recipients with phrenic nerve paralysis was not significantly longer than the other (no diaphragmatic paralysis) recipients, but there was a tendency to be longer. Diaphragmatic paralysis is most likely related to difficulty in detecting the phrenic nerve caused by adhesions, injury due to dissection, thermal injury by electrocartery, or local topical hypothermia using ice-slush. Therefore, it is important to take care of avoiding the injury of the nerve during the operation.
膈神经麻痹是心脏手术中一种有充分文献记载的并发症,但在肺移植后较少见报道。冈山大学医院对49例肺移植进行了一项回顾性研究。发现4例(8.2%)出现膈神经麻痹(3例为单侧,1例为双侧)。所有这些麻痹均短暂恢复。膈神经麻痹受者的平均通气时间、重症监护病房停留时间和住院时间并不显著长于其他(无膈肌麻痹)受者,但有延长的趋势。膈肌麻痹很可能与因粘连导致膈神经难以辨认、解剖损伤、电刀热损伤或使用冰屑局部体表低温有关。因此,术中注意避免神经损伤很重要。