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膈神经刺激用于高位颈髓损伤患者的膈肌起搏

Phrenic nerve stimulation for diaphragmatic pacing in a patient with high cervical spinal cord injury.

作者信息

Sitthinamsuwan Bunpot, Nunta-aree Sarun

机构信息

Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

出版信息

J Med Assoc Thai. 2009 Dec;92(12):1691-5.

Abstract

BACKGROUND

Phrenic nerve stimulation is a therapeutic option for patients with central hypoventilation syndrome due to brain stem and high cervical spinal cord dysfunction.

CASE REPORT

A 28-year-old woman with high cervical spinal cord injury at the level of C2 had chronic central hypoventilation syndrome, requiring long-term use of a home ventilator Preoperative end tidal CO2 and tidal volume during spontaneous breathing indicated hypoventilation syndrome. Bilateral phrenic nerve stimulation for diaphragmatic pacing was performed with spinal cord stimulators used for chronic pain. The end tidal CO2 pressure (ETCO2), tidal volume, and spontaneous breathing time have improved up to 29 months of postoperative follow-up period.

CONCLUSION

Phrenic nerve stimulation for diaphragmatic pacing can reduce all-time requirement of ventilatory support in patients with high cervical spinal cord injury.

摘要

背景

膈神经刺激是治疗因脑干和高位颈脊髓功能障碍导致的中枢性低通气综合征患者的一种治疗选择。

病例报告

一名28岁女性,C2水平高位颈脊髓损伤,患有慢性中枢性低通气综合征,需要长期在家使用呼吸机。术前自主呼吸时的呼气末二氧化碳分压和潮气量提示存在低通气综合征。使用用于慢性疼痛的脊髓刺激器进行双侧膈神经刺激以进行膈肌起搏。术后随访29个月期间,呼气末二氧化碳分压(ETCO2)、潮气量和自主呼吸时间均有所改善。

结论

膈神经刺激用于膈肌起搏可减少高位颈脊髓损伤患者对通气支持的全天需求。

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