Peterson W P, Whiteneck G G, Gerhart K A
Craig Hospital, Englewood, Colo.
Chest. 1994 Apr;105(4):1292-4. doi: 10.1378/chest.105.4.1292.
The cases of three patients with traumatic quadriplegia who had been treated with chest tubes are described. Each had been injured at a neurologic level that typically allows weaning from the ventilator, yet none was able to clear refractory atelectasis or become ventilator free. Each underwent surgery during which lung adhesions, entrapment, or deformation at the former chest tube site were identified and corrected. Subsequently, each patient cleared his atelectasis and weaned from the ventilator. These cases suggest the importance of ruling out lung deformity in individuals with ventilator-dependent quadriplegia who have had chest tubes and unexpectedly fail to wean.
本文描述了3例接受胸腔闭式引流治疗的创伤性四肢瘫痪患者的病例。每例患者的神经损伤水平通常允许撤机，但无一例能够清除难治性肺不张或脱离呼吸机。每例患者均接受了手术，术中发现并纠正了原胸腔闭式引流部位的肺粘连、肺陷闭或肺变形。随后，每例患者的肺不张均得以清除，并成功撤机。这些病例表明，对于依赖呼吸机的四肢瘫痪且曾接受胸腔闭式引流但意外无法撤机的患者，排除肺部畸形具有重要意义。
