Fodstad H, Blom S, Linderholm H
Scand J Rehabil Med. 1983;15(4):173-81.
In patients who are dependent upon respirators because of paralysis of respiratory muscles, pacemakers for electrical stimulation of the phrenic nerves, leading to contractions of the diaphragm, are available. We have implanted such diaphragm pacers in ten selected patients with partial or total respiratory insufficiency of central nervous origin. Preoperatively, transcutaneous phrenic nerve stimulation in the neck was undertaken with simultaneous fluoroscopy of the diaphragm and quantitative studies of ventilation and blood gases. Phrenic nerve stimulators were implanted bilaterally in eight and unilaterally in two patients. One patient died 3 weeks postoperatively from pneumonia, the remaining patients are entirely independent of respirator at a mean follow-up time of 20 months. Postoperative studies showed sufficient ventilation with diaphragm pacing in both sitting and recumbent body position. Their quality of life has improved. They still require permanent supervision and help with activities of daily life but all except one live in their homes. They can talk and some of them even attend school.
对于因呼吸肌麻痹而依赖呼吸机的患者，有一种可通过起搏器对膈神经进行电刺激，从而引发膈肌收缩的装置。我们已为十名选定的患有部分或完全中枢神经源性呼吸功能不全的患者植入了这种膈神经起搏器。术前，在颈部进行经皮膈神经刺激，并同时对膈肌进行荧光透视检查以及对通气和血气进行定量研究。八名患者双侧植入膈神经刺激器，两名患者单侧植入。一名患者术后3周死于肺炎，其余患者在平均20个月的随访期内完全不再依赖呼吸机。术后研究表明，无论是坐姿还是躺姿，通过膈神经起搏都能实现充足的通气。他们的生活质量有所提高。他们仍然需要长期监护以及在日常生活活动方面得到帮助，但除一人外，其他人都在家中生活。他们能够交谈，其中一些人甚至还能上学。
