深吸试验在膈膨出诊断及治疗中的作用

深吸试验在膈膨出诊断及治疗中的作用

沈玉光¹,石珍亮²,徐医军³,韩洪利³,卢喜科³,孙大强²,张逊²

1. 天津医科大学天津市胸科医院
2. 天津市胸科医院胸外科
3. 天津市胸科医院

收稿日期:2011-03-10 修回日期:2011-08-02 出版日期:2012-02-15 发布日期:2012-02-15
通讯作者: 沈玉光

the Role of Sniff Test in the Diagnosis and Treatment of Diaphragmatic Eventration

Received:2011-03-10 Revised:2011-08-02 Published:2012-02-15 Online:2012-02-15
Contact: Yu-Guang SHEN

沈玉光1 ,石珍亮2 ,徐医军3 ,韩洪利3 ,卢喜科3 ,孙大强2 ,张逊2 . 深吸试验在膈膨出诊断及治疗中的作用[J]. .

摘要/Abstract

摘要： 摘要目的：研究膈肌折叠术治疗膈肌膨升症的效果并探讨鼻吸实验在膈肌膨升症手术治疗效果预测方面的价值；方法：16例膈肌膨升症患者根据鼻吸实验结果分为两组，阳性组10例，阴性组6例。行膈肌折叠术治疗，手术前后分别对呼吸困难指数、动脉血氧分压、肺活量和一秒量进行检测，进一步比较两组手术治疗效果；结果：阳性组手术后各指标明显改善（P<0.01），阴性组中，除动脉血氧分压手术后改善外，其他指标未见明显改善。除一秒量外，阳性组和阴性组手术效果明显有差别；结论：对于有膈肌矛盾运动的膈肌膨升症患者，手术效果明显，对于没有膈肌矛盾运动的病人，手术效果有待进一步研究，鼻吸试验对于膈肌折叠术手术效果有很大的预测价值，有重要的临床意义。

关键词: 膈膨出, 深吸试验, 膈肌折叠术

Abstract: Abstract Objective：In this study we aimed to evaluate the outcome of diaphragmatic plication for unilateral diaphragmatic Eventration and to explore the role of sniff test in the diagnosis and treatment of diaphragmatic Eventration. Methods：Sixteen patients who underwent unilateral diaphragmatic plication between 2003 and 2009 were evaluated. Accroding to sniff test, ten patients(positive group) were shown to have paradoxical movement of the diaphragm and six patients(negative group) weren’t preopreatively. Before and after plication, pulmonary function, dyspnea index and arterial oxygen tension were assessed. Results：All variables showed signi?cant improvement after plication in the positive group（P<0.01）, however, in the negative group only arterial oxygen tension showed significant improvement after operation. The positive and negative groups showed significant difference of operative effective. Conclusion：Diaphragm plication provides excellent results for patients with positive result of sniff test.Sniff test has important clinical value in predicting the outcomes of diaphragmatic plication for unilateral diaphragmatic Eventration.

Key words: Diaphragmatic eventration, Sniff test, Plication