膈肌超声在危重症中的临床应用

膈肌是人体最重要的呼吸肌，而脓毒症、机械通气、营养不良等因素可导致膈肌功能障碍。超声因具有安全、无创、可重复性强等优点，近几年已被广泛应用于危重症患者的诊断及治疗。膈肌超声通过对膈肌结构和功能的评估，起到预测机械通气患者撤机结果、鉴别膈肌萎缩和膈肌麻痹、判断慢性阻塞性肺病严重程度以及评估人机同步性等多种作用，可用于临床危重患者膈肌功能障碍的诊断及治疗效果评估。

Clinical application of diaphragmatic ultrasound in critically ill patients

Diaphragm is the most important respiratory muscle. Many factors such as sepsis, mechanical ventilation and malnutrition might cause diaphragmatic dysfunction. In recent years, ultrasonography has been widely used in the diagnosis and treatment of critically ill patients due to its advantages of safety, non-invasiveness and repeatability. Through evaluation of the diaphragmatic structure and function, diaphragm ultrasound can be used to predict the withdraw from mechanical ventilation, identify the diaphragmatic weakness and paralysis, estimate the severity of chronic obstructive pulmonary disease, and evaluate the patient-ventilator synchrony in mechanically ventilated patients. Diaphragm ultrasound is useful for diagnosis and therapeutic effect evaluation of diaphragmatic dysfunction in critically ill patients.