Sandham J D, Shaw D T, Guenter C A
Chest. 1977 Jul;72(1):96-8. doi: 10.1378/chest.72.1.96.
This report documents the first known case of bilateral diaphragmatic paralysis following blunt trauma to the chest. The important role of diaphragmatic function in maintaining ventilation, particularly with the patient in the supine position, is illustrated by the reduced total lung capacity, functional residual capacity, and vital capacity. Severe hypoxemia with the patient in the supine position, was markedly improved by elevation of the patient to 30 degree and was further improved by sitting the patient upright. Following an initial period of acute respiratory failure, the patient was managed acceptably by maintaining an elevated position for sleeping until diaphragmatic function returned, about nine months after the injury.
本报告记录了首例已知的胸部钝性创伤后双侧膈神经麻痹病例。膈功能在维持通气中发挥的重要作用，尤其是在患者仰卧位时，通过总肺容量、功能残气量和肺活量的降低得以体现。患者仰卧位时出现严重低氧血症，将患者抬高至30度后明显改善，患者坐直后进一步改善。在经历了最初的急性呼吸衰竭期后，通过保持睡眠时的抬高体位直至膈功能恢复，患者得到了可接受的管理，膈功能恢复约在受伤后九个月。
