Chroni E, Patel R L, Taub N, Venn G E, Howard R S, Panayiotopoulos C P
Department of Clinical Neurophysiology, United Medical School, St. Thomas' Hospital, London, England.
Acta Neurol Scand. 1995 Apr;91(4):255-9. doi: 10.1111/j.1600-0404.1995.tb07000.x.
A prospective electrophysiological study of phrenic nerve was performed in 59 subjects undergoing open-heart surgery. The nerve was stimulated percutaneously at the neck and the diaphragmatic response was recorded with surface electrodes placed over the 8th intercostal space. The latency, amplitude, duration and area of the evoked response were measured before and after the operation. Post-operatively no response was elicited in 2 patients bilaterally, in 5 from the left and in 2 from the right. Comparison of the post-operative with the pre-operative group values in the remaining subjects showed that the amplitude and area of the left phrenic were lower in the post-operative study, indicating that some of the nerve fibres were not conducting. There were no statistically significant differences between pre and post-operative values of latency or duration on the left or any of the parameters on the right. Our findings suggest that the amplitude and area of the diaphragmatic response are more sensitive than latency in detecting phrenic nerve paresis associated with open-heart surgery.
对59例接受心脏直视手术的患者进行了一项关于膈神经的前瞻性电生理研究。在颈部经皮刺激神经，并使用置于第8肋间的表面电极记录膈肌反应。在手术前后测量诱发反应的潜伏期、振幅、持续时间和面积。术后，2例患者双侧未引出反应，5例左侧未引出反应，2例右侧未引出反应。其余受试者术后组值与术前组值比较显示，术后研究中左侧膈神经的振幅和面积较低，表明一些神经纤维未传导。左侧潜伏期或持续时间的术前和术后值之间，或右侧任何参数之间，均无统计学显著差异。我们的研究结果表明，在检测与心脏直视手术相关的膈神经麻痹方面，膈肌反应的振幅和面积比潜伏期更敏感。
