[外周神经重建手术技术在损伤膈神经修复瘫痪膈肌中的应用]。

Nihon Geka Gakkai zasshi Pub Date : 2016-07-01
Jun Kobayashi
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引用次数: 0

摘要

膈神经损伤常引起膈功能障碍。在治疗支气管源性、纵隔或颈部肿瘤的胸椎或颈部手术中,如横断或挤压等医源性损伤可引起膈神经损伤。横膈膜牵拉术是将松弛的半横膈膜用过缝合的方法拉紧。虽然单侧膈肌麻痹患者有严重的呼吸困难和其他症状,但最基本的治疗应该是恢复瘫痪膈肌的功能。周围神经重建技术是治疗膈神经损伤的有效方法。在许多临床病例中,神经再传导后的肌肉收缩和膈功能得到恢复,动物模型实验结果良好。重建神经的手术,如修复,移植物,或转移可能适用于更多的病例膈神经损伤,以改善手术治疗局部晚期恶性肿瘤的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[APPLICATION OF RECONSTRUCTIVE SURGICAL TECHNIQUES FOR THE PERIPHERAL NERVE TO INJURED PHRENIC NERVE TO RESTORE THE PARALYZED DIAPHRAGM].

Phrenic nerve injury often causes diaphragmatic dysfunction. Damage to the phrenic nerve may be caused by iatrogenic injury such as transection or crush during thoracic or neck surgery to treat bronchogenic, mediastinal, or neck tumors. Plication of the diaphragm is a procedure in which the flaccid hemidiaphragm is tautened by oversuturing it. Although it has been offered to patients with unilateral diaphragmatic paralysis who have severe dyspnea and other symptoms, the essential treatment should be restoration of the function to the paralyzed diaphragm. Established reconstructive techniques for peripheral nerves are indicated to treat some phrenic nerve injury cases. Muscle contraction and diaphragmatic function following nerve reconduction is recovered in many clinical cases, and favorable experimental results were seen in animal models. Reconstructive nerve procedures such as repair, graft, or transfer may be indicated in more cases of phrenic nerve injury to improve prognostic outcomes of surgery to treat locally advanced malignancies.

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