膈神经和肋间神经移位术中呼吸功能的变化

The changes of respiratory function in the transfer of phrenic and intercostal nerve

目的:了解一侧膈神经和部分肋间神经同时移位治疗臂丛神经损伤后,对呼吸功能的影响。方法:选择28例臂丛神经根损伤,行膈神经和肋间神经同时切断前后,测量呼吸潮气量(tidal volume,Vt),频率(frequency,f),呼气末二氧化碳分压(end tidal carban dioxide,PetCO_2)和脉搏血氧饱和度(pulse oxygen saturation,SpO_2)的变化。结果:该两神经同时切断后,Vt,f有所下降,PetCO_2升高,表示呼吸功能受到抑制。但在90分钟后,呼吸功能已开始恢复。结论:同时进行膈神经和部分肋间神经移位,对患者的呼吸功能有明显影响。因此,在行该组手术麻醉时,应确保足够的通气量。

<Abatract>Objective: To evaluate the influence of the simutaneous transfer of phrenic and intercostal nerves on the respiratory function in brachial plexus injures. Methods:28 patients of brachial plexus root injuries who underwent simutaneous phrenic and intercostal nerve transfer were selected. The changes in tidal volume (Vt), frequency (f), end tidal carbon dioxide pressure (petCO2) and pulse oxygen saturation (SpO2) were measured before and after nerve harvesting. Results: When these two nerves were cut simutaneously, Vt and f decreased whereas PetCO2 increased, indicating the inhibition of respiratory function. However the inhibited respiration recovered in 90 minutes. Conclusions: Simutaneous section of phrenic and intercostal nerve has obvious influence on the respiratory function. Therefore, it's essential to maintain minute volume in anaesthesia of this procedure.