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目的总结临床膈神经移位治疗产瘫节前损伤的疗效及其对肺功能的影响。方法本组16例,皆在全麻下行膈神经移位修复撕脱的臂丛神经,术后观察膈神经移位后患儿上肢功能恢复及呼吸功能情况。结果随访2～6年,按照Mallet评分标准评定膈神经移位功能恢复情况,优5例,良7例,可3例,差1例,优良率75%,3个月以内优良率80%。11例呼吸平稳;4例呼吸急促,术后1周平稳;1例发生肺炎,经治疗10余天后呼吸平稳。结论早期膈神经移位治疗产瘫节前损伤疗效满意,肥胖及体弱新生儿膈神经移位时需慎重,切取一侧膈神经对患儿呼吸功能无明显影响。
Objective To summarize the curative effect of clinical phrenic nerve transposition on prenatal injury of paraplegia and its effect on pulmonary function. Methods The group of 16 patients, all under the phrenic nerve transposition to repair avulsion brachial plexus after operation, after the observation of phrenic nerve displacement in children with upper limb function recovery and respiratory function. Results The patients were followed up for 2 to 6 years. The recovery of phrenic nerve function was evaluated according to the Mallet score. The results were excellent in 5 cases, good in 7 cases, fair in 3 cases and poor in 1 case. The excellent and good rate was 75%. The excellent and good rate was 80% in 3 months. 11 cases of stable breathing; 4 cases of shortness of breath, stable after 1 week; 1 case of pneumonia, after more than 10 days of treatment, breathing stable. Conclusions The early phrenic nerve transposition is satisfactory for the treatment of paraplegic preganglionic lesion. The obstructive and frail neonatal phrenic nerve should be carefully treated. The phrenic nerve of one side has no significant effect on the respiratory function.