- 期刊
Postoperative Diaphragmatic Dysfunction in Patients Undergoing Open-Heart Surgery
開心手術後病人發生橫隔膜功能失調
摘要
本文旨在研究從 1990 年十月至 1992 年十月， 200 位接受開心手術患者中，手術前橫隔功能都是正常的；其中有 26 位於術後發生左橫隔膜上昇， 174 位患者術後橫隔功能是正常的。比較這兩組病人手術前後的資料，結果我們發現發生左橫隔異常組的術中血管交叉阻斷時問明顯比沒發生異常組長，而且年齡比較大。發生左橫隔異常的原因，並不十分清楚，但可知和曰術中冰水溫度有關；口術中牽扯心包膜壁有關；曰手術時問長短有關。左橫隔異常的患者容易發生肺功能失調，延長住加護病房的時間，甚至於導至手術後病人死亡。本文結論為如能減少血管交叉阻斷時間，可減少發生左橫隔異常的發生，並減少術後併發症的產生。
關鍵字
無資料並列摘要
Diaphragmatic elevation after cardiac surgery may result in compromized post operative respiratory function, prolonged ventilator use, longer intensive care unit (ICU) stays, poor quality of life and even mortality. 200 patients receiving open-heart surgery during the two years from October 1990 to October 1992 were studied retrospectively. 26 patients developed postoperative diaphragmatic elevation (Group 2). On the other hand, 174 patients did not (Group 1). The mean age of Group 1 (37.3±20.0 years) was younger than that of Group 2 (57.4±9.1 years), P＜0.0001. The mean aortic cross- clamp time was 70.1±38.1 minutes in Group 1. On the other hand, Group 2 had a longer crossclamp time (84.5 ± 31.3 Minutes), p ＜0.03. Our study revealed that the patients who suffered post operative diaphragmatic dysfunction were older and had a longer aortic crossclamp time than the patients who did not.
延伸閱讀
- Chin, H. K., Chang, Y. P., & Chao, C. S. (2008). 經由胸腔外繞道手術治療主動脈幹分支之開口閉塞－病例報告及文獻回顧. The Kaohsiung Journal of Medical Sciences, 24(10), 536-541. https://www.airitilibrary.com/Article/Detail?DocID=1607551X-200810-24-10-536-541-a
- Hsu, H. T., Lin, J. Y., Tseng, H. I., Chang, Y. L., Yu, K. L., Cheng, K. I., & Tang, C. S. (2004). 全靜脈注射麻醉應用於先天性橫膈膜疝氣修補術－病例報告. The Kaohsiung Journal of Medical Sciences, 20(9), 465-469. https://www.airitilibrary.com/Article/Detail?DocID=02575655-200409-20-9-465-469-a
- 楊尚賢、古婉珍、陳墩祿（1992）。小樑切除術後之巨大非猛爆性脈絡膜上出血―病例报告。中華民國眼科醫學會雜誌，31(1)，101-106。https://doi.org/10.30048/ACTASOS.199203.0020
- Spielberger, J., Liao, C. X., Tan, P. H., & Yang, L. C. (2006). 施行硬脊膜外導管置入做為術後止痛意外合併硬脊膜外及硬脊膜下阻斷之病例報告. Acta Anaesthesiologica Taiwanica, 44(3), 173-176. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200609-44-3-173-176-a
- Lin, H. Y., Wu, H. S., Peng, T. H., Yeh, Y. J., Cheng, I. C., Lin, L. S., & Liu, C. H. (1997). 施行硬脊膜外止痛術時因硬脊膜穿刺造成意外氣腦及呼吸抑制之病例報告. Acta Anaesthesiologica Sinica, 35(2), 119-123. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199706-201904160019-201904160019-119-123