分娩外傷に伴う横隔膜弛緩症に対し横隔膜縫縮術を施行した10例の検討

概要

論文の詳細を見る
Diaphragmatic plication was succesesfully performed in 10 patients whose respiratory status was severely compromised by diaphragmatic eventration consequent to birth injury. Although one patient needed re-plication 16 days after the initial operation, symptoms singificantly improved in all 10 patients after surgery. Postoperative ileus was experienced in one patient, but there were no other serious postoperative complications. In all cases endotracheal tubes were removed within a few days after surgery, and no other respiratory management was required except for one case. This patient, whose cource was complicated by cardiac anomaly and severe cerebral infarction recognized before plication, reqired oxygen administration after weaning from mechanical ventilation. In conclusion, our experiecce indicates that diaphragmatic plication is safe and effective procedure for neonates or small infants with respiratory disturbance due to aquired diaphragmatic eventraton. Plication should be performed promptly in patients who need mechanical ventilation, and in those patients who show paradoxical mediastinal movement and require oxygen therapy. Diaphragmatic plication should be considered as a treatment of choice rather than employing a long lasting conservative management.
日本小児外科学会の論文
1992-10-20