膈神经传导时间在麻醉复苏中的应用

目的:探讨膈神经传导时间(PNCT)在麻醉复苏过程中对膈肌功能的监测作用。方法: 对8例手术病人观察全麻使用肌松药前后颤搐性跨膈压(Pdi_(t))和PNCT的变化。结果: 8例手术病人在全麻前:Pdi(t)为(23.7±2.4) cmH₂O,左、右侧PNCT分别为(5.7±1.3) ms和(5.6±0.9) ms;全麻使用肌松药后:Pdi_(t)下降到(11.5±3.4) cmH2O(下降率51.5%,P＜0.01),而左、右侧PNCT则分别延长为(6.1±1.3)ms和(6.4±0.6)ms,并随Pdi_(t)的恢复而逐步缩短。结论:肌松药诱发膈肌无力和引起双侧PNCT延长,且PNCT随着Pdi_(t)的恢复而缩短; PNCT的测定有助于间接监测全麻使用肌松药期间膈肌肌力的动态变化。

The application of phrenic nerve conduction time in the resuscitation of anaesthesia

AIM:To investigate the application of phrenic nerve conduction time(PNCT) in the recovery of general anaesthesia.METHODS:Pdi_(t) and PNCT were measured by cervical magnetic stimulation of phrenic nerves in 8 patients before and after the administration of muscle relaxant.RESULTS:Pdi_(t) was reduced from (23.7±2.4) cmH₂O to (11.5±3.4) cmH₂O (reduction rate: 51.5%, P＜0.01) after the administration of muscle relaxant. The PNCT were (5.73±1.33) ms on the left side and (5.63±0.91) ms on the right side before the administration of muscle relaxant and prolonged to(6.1±1.3) ms and(6.4±0.6) ms and shortened as the Pdi_(t) recovered. CONCLUSIONS:Pdi(t)was reduced and PNCT was prolonged after the administration of muscle relaxant and the PNCT were shortened as the Pdi(t)recovered.The PNCT could be used to estimate the diaphragmatic function indirectly.