膈肌麻痹所致新生儿呼吸急促：一例报告

Neonatal tachypnea caused by diaphragmatic paralysis: A case report.

作者信息

Zeng Yan, Luo Pei, Zhao Di-Ran, Wang Feng-Yang, Song Bin

机构信息

Department of Pediatrics, People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China.

Department of Ultrasound, People's Hospital of Deyang City, Deyang 618000, Sichuan Province, China.

出版信息

World J Clin Cases. 2024 Aug 6;12(22):5253-5257. doi: 10.12998/wjcc.v12.i22.5253.

DOI:10.12998/wjcc.v12.i22.5253

PMID:39109022

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11238795/

Abstract

BACKGROUND

Diaphragmatic paralysis is typically associated with phrenic nerve injury. Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.

CASE SUMMARY

We report a 39-week-old newborn delivered vaginal forceps who presented with tachypnea but without showing other birth-trauma-related manifestations. The infant was initially diagnosed with pneumonia. However, the newborn still exhibited tachypnea despite effective antibiotic treatment. Chest radiography revealed right diaphragmatic elevation. M-mode ultrasonography revealed decreased movement of the right diaphragm. The infant was subsequently diagnosed with diaphragmatic paralysis. After 4 weeks, tachypnea improved. Upon re-examination using M-mode ultrasonography, the difference in bilateral diaphragmatic muscle movement was smaller than before.

CONCLUSION

Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation.

摘要

背景

膈神经麻痹通常与膈神经损伤有关。新生儿膈神经麻痹的诊断很容易被漏诊，因为其表现多样且通常不具有特异性。

病例摘要

我们报告一例39周龄经阴道产钳分娩的新生儿，该患儿表现为呼吸急促，但未表现出其他与产伤相关的症状。该婴儿最初被诊断为肺炎。然而，尽管进行了有效的抗生素治疗，该新生儿仍表现为呼吸急促。胸部X线检查显示右侧膈肌抬高。M型超声检查显示右侧膈肌运动减弱。该婴儿随后被诊断为膈神经麻痹。4周后，呼吸急促症状有所改善。再次使用M型超声检查时，双侧膈肌运动的差异比之前减小。