Pons Odena M, Piqueras Marimbaldo I, Colomer Oferil J, Segura Matute S, Palomeque Rico A
Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
An Pediatr (Barc). 2010 Apr;72(4):267-71. doi: 10.1016/j.anpedi.2009.11.017. Epub 2010 Feb 6.
Diaphragmatic bilateral palsy is uncommon in children. The most important etiologies are thoracic surgery and obstetric trauma. Respiratory muscle impairment is a rare phenomenon in patients with Charcot-Marie-Tooth disease (CMT). However, it can be associated with restrictive pulmonary impairment, phrenic nerve dysfunction or thoracic cage abnormalities. We report two paediatric cases of CMT disease with type 2 respiratory failure due to diaphragmatic dysfunction. In both cases treatment with non-invasive mechanical ventilation resulted in satisfactory clinical improvement. Evidence of phrenic damage was the main clue in one patient in order to obtain an accurate diagnostic of her disease.
双侧膈肌麻痹在儿童中并不常见。最重要的病因是胸外科手术和产伤。呼吸肌受损在夏科-马里-图斯病(CMT)患者中是一种罕见现象。然而,它可能与限制性肺功能损害、膈神经功能障碍或胸廓异常有关。我们报告两例因膈肌功能障碍导致2型呼吸衰竭的CMT病儿科病例。在这两例病例中,无创机械通气治疗均取得了令人满意的临床改善。膈神经损伤的证据是其中一名患者准确诊断其疾病的主要线索。