超声评估膈肌功能的方法及其在临床中的应用

The Method of Ultrasonic Evaluation of Diaphragmatic Function and its Clinical Application

膈肌是重要的呼吸肌之一,膈肌功能异常可明显影响呼吸功能。目前临床可使用超声动态观察膈肌厚度、膈肌移动度等指标,并通过公式计算膈肌厚度分数、膈肌收缩速度等指标综合评估患者膈肌功能。临床中评估臂丛神经阻滞伴随的膈肌功能障碍、慢性阻塞性肺病的肺功能及运动耐量、重症患者及麻醉后患者的撤机拔管时机及早期发现慢性心衰患者的吸气肌无力和运动耐量下降等可对患者的病情及治疗疗效提供动态监测并能够实现早期干预甚至改善预后。本文主要就超声评估膈肌功能的相关指标及其测量方法、膈肌超声在临床中的应用等进行综述。

Diaphragm is one of the important respiratory muscles.Abnormal diaphragm function can obviously affect respiratory function.At present,ultrasound can be used to dynamically observe the diaphragm thickness,diaphragm excursion and other indicators,and calculate the diaphragm thickness fraction,diaphragmatic velocity and other indicators by formula to comprehensively evaluate the diaphragm function.Clinical evaluation of diaphragmatic dysfunction associated with brachial plexus block,lung function and exercise tolerance of chronic obstructive pulmonary disease,timing of weaning and extubation of critically ill patients and patients after anesthesia,and early detection of inspiratory muscle weakness and decreased exercise tolerance in patients with chronic heart failure can provide dynamic monitoring of the patient's condition and treatment efficacy,and can achieve early intervention and even improve prognosis.This article mainly reviews the related indicators and measurement methods of ultrasound evaluation of diaphragmatic function,and the clinical application of diaphragmatic ultrasound.