Bowen T E, Zajtchuk R, Albus R A
Ann Thorac Surg. 1982 Feb;33(2):184-8. doi: 10.1016/s0003-4975(10)61907-8.
A neonate had paralysis of the right hemidiaphragm secondary to brachial plexus birth trauma. Conventional diaphragmatic plication, performed on two separate occasions, failed to correct the ventilatory impairment, and mechanical ventilatory dependence persisted. Ventilatory insufficiency was subsequently corrected by total replacement of the right hemidiaphragm with Marlex mesh. This procedure ablated paradoxical motion of the right hemidiaphragm and arrested detrimental shifts of the mobile infantile mediastinum. The good result was immediate and long-lasting; there was no major prosthesis-related growth deformity 31/2 years later. Prosthetic fixation of the paralyzed diaphragm is not indicated as a primary procedure, but should be reserved for the occasional patient in whom conventional plication has failed.
一名新生儿因臂丛神经产伤继发右侧半膈肌麻痹。在两个不同时间进行的传统膈肌折叠术未能纠正通气障碍，机械通气依赖持续存在。随后通过用Marlex网片完全置换右侧半膈肌纠正了通气不足。该手术消除了右侧半膈肌的反常运动，并阻止了活动的婴儿纵隔的有害移位。效果立竿见影且持久；3年半后未出现与假体相关的严重生长畸形。对于麻痹的膈肌，假体固定不作为首选手术，而应保留给传统折叠术失败的少数患者。
