Efthimiou J, Butler J, Benson M K, Westaby S
Department of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
Thorax. 1991 May;46(5):351-4. doi: 10.1136/thx.46.5.351.
Bilateral diaphragm paralysis is a rare but important complication of open heart surgery. Two cases were found among 360 prospectively studied patients undergoing open heart surgery during one year. Both patients had insulin dependent diabetes with peripheral neuropathy and this may have contributed to their diaphragm paralysis. The patients were studied postoperatively for one year with measurements of lung function, nocturnal oximetry, diaphragmatic function, and phrenic nerve conduction. Treatment with intermittent positive airway pressure ventilation by nasal mask was effective in both patients. After nine months one patient had recovered completely with normal phrenic nerve conduction and diaphragmatic function; the other continues most of his normal daytime activities, but still requires nasal positive airway pressure ventilation for six hours at night.
双侧膈肌麻痹是心脏直视手术中一种罕见但重要的并发症。在一年中对360例接受心脏直视手术的患者进行前瞻性研究时发现了2例。两名患者均患有胰岛素依赖型糖尿病并伴有周围神经病变，这可能是导致其膈肌麻痹的原因。术后对患者进行了为期一年的研究，测量了肺功能、夜间血氧饱和度、膈肌功能和膈神经传导。两名患者采用经鼻面罩间歇性正压通气治疗均有效。9个月后，一名患者完全康复，膈神经传导和膈肌功能正常；另一名患者大部分日常活动正常，但夜间仍需经鼻正压通气6小时。
