Kříž J, Jaroščiaková S, Šedivá K, Hyšperská V, Čadová K, Přikrylová Z
Spinální jednotka při Klinice rehabilitace a tělovýchovného lékařství 2. lékařské fakulty a Fakultní nemocnice v Motole, Praha.
Ortopedicko-traumatologická klinika 3. lékařské fakulty a Fakultní nemocnice Královské Vinohrady, Praha.
Acta Chir Orthop Traumatol Cech. 2023;90(1):59-62.
Patients with impaired diaphragm function are dependent on long-term mechanical ventilation. It is associated with numerous health complications as well as significant economic burden. Intramuscular diaphragm stimulation through laparoscopic implantation of pacing electrodes is a safe method which enables restoring breathing using diaphragm in a considerable number of patients. The first implantation of diaphragm pacing system in the Czech Republic was performed in a thirty-four-year-old patient suffering from a high-level cervical spinal cord lesion. After eight years of mechanical ventilation support, just five months from initiation of stimulation, the patient is able to breathe spontaneously for ten hours per day on average, with expected total weaning. Once the insurance companies decide to reimburse the pacing system, a widespread use of the method even in patients with other diagnoses, including children, is expected. Key words: electrical stimulation, diaphragm, spinal cord injury, laparoscopic surgery.
膈肌功能受损的患者依赖长期机械通气。这与众多健康并发症以及巨大的经济负担相关。通过腹腔镜植入起搏电极进行膈肌肌内刺激是一种安全的方法，能使相当多的患者利用膈肌恢复呼吸。捷克共和国首例膈肌起搏系统植入手术是在一名34岁患有高位颈脊髓损伤的患者身上进行的。在接受八年机械通气支持后，从开始刺激仅五个月起，该患者平均每天能够自主呼吸十小时，有望完全脱机。一旦保险公司决定报销起搏系统费用，预计该方法甚至在包括儿童在内的其他诊断患者中也会得到广泛应用。关键词：电刺激、膈肌、脊髓损伤、腹腔镜手术。
