Otte J B, Mignon T, Kartheuser A, Moulin D, Claus D, Lerut T, Corneille P, Gruwez J A
Acta Chir Belg. 1982 Nov-Dec;82(6):559-68.
Diaphragmatic relaxation is either congenital, due to muscular dysplasia ("eventration"), or acquired and related to phrenic nerve lesion ("paralysis"); phrenic nerve paralysis can be a complication of a difficult delivery (breech presentation or forceps) or of a surgical--mostly cardiac--procedure. The authors review their own experience (12 eventrations and 9 paralysis) and recall the pathophysiology, the symptoms and treatment of this condition. They recommend the surgical plication, as most experienced authors do, when the symptoms are not completely alleviated by medical treatment which should be of short duration and must include intubation and assisted ventilation in case of acute respiratory distress.
膈肌松弛要么是先天性的,由肌肉发育异常(“膈膨升”)引起,要么是后天获得性的,与膈神经损伤(“麻痹”)有关;膈神经麻痹可能是难产(臀位分娩或使用产钳)或外科手术(主要是心脏手术)的并发症。作者回顾了他们自己的经验(12例膈膨升和9例麻痹),并回顾了这种情况的病理生理学、症状和治疗方法。他们建议,如同大多数经验丰富的作者一样,当症状没有通过短期的药物治疗完全缓解,且在急性呼吸窘迫情况下必须包括插管和辅助通气时,应进行手术折叠术。