超声评估膈肌在临床麻醉中的应用进展
摘要
<正>膈肌是重要的呼吸肌,肺总吸气量的75%由膈肌负担,膈肌受损会防害通气和氧气输送[1-2]。膈肌还有其他功能,例如增加腹内压帮助排尿、排便、呕吐,在食管裂孔处施加压力而预防胃-食管反流[2]。膈肌功能不全是呼吸困难、术后肺部并发症的常见病因,上腹部手术、创伤、肿瘤、机械通气、慢性肺部疾病、肌间沟神经阻滞等均会导致膈肌功能不全[3]。观察和测量膈肌的运动对于膈肌功能的评估十分重要,传统评估膈肌功能的方法有胸部X线片、直立位荧光透视、MRI、
引文
[1] Boon AJ,O'Gorman C.Ultrasound in the assessment of respiration.J Clin Neurophysiol,2016,33(2):112-119.
[2] Testa A,Soldati G,Giannuzzi R,et al.Ultrasound M-mode assessment of diaphragmatic kinetics by anterior transverse scanning in healthy subjects.Ultrasound Med Biol,2011,37(1):44-52.
[3] Kharma N.Dysfunction of the diaphragm:imaging as a diagnostic tool.Curr Opin Pulm Med,2013,19(4):394-398.
[4] Nason LK,Walker CM,McNeeley MF,et al.Imaging of the diaphragm:anatomy and function.Radiographics,2012,32(2):E51-E70.
[5] Sferrazza Papa GF,Pellegrino GM,Di Marco F,et al.A review of the ultrasound assessment of diaphragmatic function in clinical practice.Respiration,2016,91(5):403-411.
[6] Naik LY,Sondekoppam RV,Jenkin Tsui J,et al.An ultrasound-guided ABCDE approach with a sniff test to evaluate diaphragmatic function without acoustic windows.Can J Anaesth,2016,63(10):1199-1200.
[7] Houston JG,Angus RM,Cowan MD,et al.Ultrasound assessment of normal hemidiaphragmatic movement:relation to inspiratory volume.Thorax,1994,49(5):500-503.
[8] Roberts HC.Imaging the diaphragm.Thorac Surg Clin,2009,19(4):431-450.
[9] Orde SR,Boon AJ,Firth DG,et al.Diaphragm assessment by two dimensional speckle tracking imaging in normal subjects.BMC Anesthesiol,2016,16(1):43.
[10] Haber K,Asher M,Freimanis AK.Echographic evaluation of diaphragmatic motion in intra-abdominal diseases.Radiology,1975,114(1):141-144.
[11] Cohen E,Mier A,Heywood P,et al.Excursion-volume relation of the right hemidiaphragm measured by ultrasonography and respiratory airflow measurements.Thorax,1994,49(9):885-889.
[12] Houston JG,Fleet M,McMillan N,et al.Ultrasonic assessment of hemidiaphragmatic movement:an indirect method of evaluating mediastinal invasion in non-small cell lung cancer.Br J Radiol,1995,68(811):695-699.
[13] Houston JG,Morris AD,Howie CA,et al.Technical report:quantitative assessment of diaphragmatic movement--a reproducible method using ultrasound.Clin Radiol,1992,46(6):405-407.
[14] Boon AJ,Harper CJ,Ghahfarokhi LS,et al.Two-dimensional ultrasound imaging of the diaphragm:quantitative values in normal subjects.Muscle Nerve,2013,47(6):884-889.
[15] Harper CJ,Shahgholi L,Cieslak K,et al.Variability in diaphragm motion during normal breathing,assessed with B-mode ultrasound.J Orthop and Sports Phys Ther,2013,43(12):927-931.
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[18] Khurana J,Gartner SC,Naik L,et al.Ultrasound identification of diaphragm by novices using ABCDE technique.Reg Anesth Pain Med,2018,43(2):161-165.
[19] Gottesman E,McCool FD.Ultrasound evaluation of the paralyzed diaphragm.Am J Respir Crit Care Med,1997,155(5):1570-1574.
[20] Vivier E,Mekontso Dessap A,Dimassi S,et al.Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation.Intensive Care Med,2012,38(5):796-803.
[21] Kaufman MR,Elkwood AI,Rose MI,et al.Surgical treatment of permanent diaphragm paralysis after interscalene nerve block for shoulder surgery.Anesthesiology,2013,119(2):484-487.
[22] Kim BG,Han JU,Song JH,et al.A comparison of ultrasound-guided interscalene and supraclavicular blocks for post-operative analgesia after shoulder surgery.Acta Anaesthesiol Scand,2017,61(4):427-435.
[23] Tran DQ,Elgueta MF,Aliste J,et al.Diaphragm-sparing nerve blocks for shoulder surgery.Reg Anesth Pain Med,2017,42(1):32-38.
[24] Wu A,Drummond GB.Respiratory muscle activity and respiratory obstruction after abdominal surgery.Br J Anaesth,2006,96(4):510-515.
[25] Kim SH,Na S,Choi JS,et al.An evaluation of diaphragmatic movement by M-mode sonography as a predictor of pulmonary dysfunction after upper abdominal surgery.Anesth Analg,2010,110(5):1349-1354.
[26] Latimer RG,Dickman M,Day WC,et al.Ventilatory patterns and pulmonary complications after upper abdominal surgery determined by preoperative and postoperative computerized spirometry and blood gas analysis.Am J Surg,1971,122(5):622-632.
[27] Goligher EC,Laghi F,Detsky ME,et al.Measuring diaphragm thickness with ultrasound in mechanically ventilated patients:feasibility,reproducibility and validity.Intensive Care Med,2015,41(4):642-649.
[28] Flevari A,Lignos M,Konstantonis D,et al.Diaphragmatic ultrasonography as an adjunct predictor tool of weaning success in patients with difficult and prolonged weaning.Minerva Anestesiol,2016,82(11):1149-1157.
[29] Sanchez de Toledo J,Munoz R,Landsittel D,et al.Diagnosis of abnormal diaphragm motion after cardiothoracic surgery:ultrasound performed by a cardiac intensivist vs.fluoroscopy.Congenit Heart Dis,2010,5(6):565-572.
[30] Tsui BC,Tsui J.ABC Diaphragmatic evaluation for neonates.Paediatr Anaesth,2016,26(7):768-769.
[31] Zambon M,Greco M,Bocchino S,et al.Assessment of diaphragmatic dysfunction in the critically ill patient with ultrasound:a systematic review.Intensive Care Med,2017,43(1):29-38.
[2] Testa A,Soldati G,Giannuzzi R,et al.Ultrasound M-mode assessment of diaphragmatic kinetics by anterior transverse scanning in healthy subjects.Ultrasound Med Biol,2011,37(1):44-52.
[3] Kharma N.Dysfunction of the diaphragm:imaging as a diagnostic tool.Curr Opin Pulm Med,2013,19(4):394-398.
[4] Nason LK,Walker CM,McNeeley MF,et al.Imaging of the diaphragm:anatomy and function.Radiographics,2012,32(2):E51-E70.
[5] Sferrazza Papa GF,Pellegrino GM,Di Marco F,et al.A review of the ultrasound assessment of diaphragmatic function in clinical practice.Respiration,2016,91(5):403-411.
[6] Naik LY,Sondekoppam RV,Jenkin Tsui J,et al.An ultrasound-guided ABCDE approach with a sniff test to evaluate diaphragmatic function without acoustic windows.Can J Anaesth,2016,63(10):1199-1200.
[7] Houston JG,Angus RM,Cowan MD,et al.Ultrasound assessment of normal hemidiaphragmatic movement:relation to inspiratory volume.Thorax,1994,49(5):500-503.
[8] Roberts HC.Imaging the diaphragm.Thorac Surg Clin,2009,19(4):431-450.
[9] Orde SR,Boon AJ,Firth DG,et al.Diaphragm assessment by two dimensional speckle tracking imaging in normal subjects.BMC Anesthesiol,2016,16(1):43.
[10] Haber K,Asher M,Freimanis AK.Echographic evaluation of diaphragmatic motion in intra-abdominal diseases.Radiology,1975,114(1):141-144.
[11] Cohen E,Mier A,Heywood P,et al.Excursion-volume relation of the right hemidiaphragm measured by ultrasonography and respiratory airflow measurements.Thorax,1994,49(9):885-889.
[12] Houston JG,Fleet M,McMillan N,et al.Ultrasonic assessment of hemidiaphragmatic movement:an indirect method of evaluating mediastinal invasion in non-small cell lung cancer.Br J Radiol,1995,68(811):695-699.
[13] Houston JG,Morris AD,Howie CA,et al.Technical report:quantitative assessment of diaphragmatic movement--a reproducible method using ultrasound.Clin Radiol,1992,46(6):405-407.
[14] Boon AJ,Harper CJ,Ghahfarokhi LS,et al.Two-dimensional ultrasound imaging of the diaphragm:quantitative values in normal subjects.Muscle Nerve,2013,47(6):884-889.
[15] Harper CJ,Shahgholi L,Cieslak K,et al.Variability in diaphragm motion during normal breathing,assessed with B-mode ultrasound.J Orthop and Sports Phys Ther,2013,43(12):927-931.
[16] Fedullo AJ,Lerner RM,Gibson J,et al.Sonographic measurement of diaphragmatic motion after coronary artery bypass surgery.Chest,1992,102(6):1683-1686.
[17] Tsui JJ,Tsui BC.A novel systematic ABC approach to diaphragmatic evaluation(ABCDE).Can J Anaesth,2016,63(5):636-637.
[18] Khurana J,Gartner SC,Naik L,et al.Ultrasound identification of diaphragm by novices using ABCDE technique.Reg Anesth Pain Med,2018,43(2):161-165.
[19] Gottesman E,McCool FD.Ultrasound evaluation of the paralyzed diaphragm.Am J Respir Crit Care Med,1997,155(5):1570-1574.
[20] Vivier E,Mekontso Dessap A,Dimassi S,et al.Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation.Intensive Care Med,2012,38(5):796-803.
[21] Kaufman MR,Elkwood AI,Rose MI,et al.Surgical treatment of permanent diaphragm paralysis after interscalene nerve block for shoulder surgery.Anesthesiology,2013,119(2):484-487.
[22] Kim BG,Han JU,Song JH,et al.A comparison of ultrasound-guided interscalene and supraclavicular blocks for post-operative analgesia after shoulder surgery.Acta Anaesthesiol Scand,2017,61(4):427-435.
[23] Tran DQ,Elgueta MF,Aliste J,et al.Diaphragm-sparing nerve blocks for shoulder surgery.Reg Anesth Pain Med,2017,42(1):32-38.
[24] Wu A,Drummond GB.Respiratory muscle activity and respiratory obstruction after abdominal surgery.Br J Anaesth,2006,96(4):510-515.
[25] Kim SH,Na S,Choi JS,et al.An evaluation of diaphragmatic movement by M-mode sonography as a predictor of pulmonary dysfunction after upper abdominal surgery.Anesth Analg,2010,110(5):1349-1354.
[26] Latimer RG,Dickman M,Day WC,et al.Ventilatory patterns and pulmonary complications after upper abdominal surgery determined by preoperative and postoperative computerized spirometry and blood gas analysis.Am J Surg,1971,122(5):622-632.
[27] Goligher EC,Laghi F,Detsky ME,et al.Measuring diaphragm thickness with ultrasound in mechanically ventilated patients:feasibility,reproducibility and validity.Intensive Care Med,2015,41(4):642-649.
[28] Flevari A,Lignos M,Konstantonis D,et al.Diaphragmatic ultrasonography as an adjunct predictor tool of weaning success in patients with difficult and prolonged weaning.Minerva Anestesiol,2016,82(11):1149-1157.
[29] Sanchez de Toledo J,Munoz R,Landsittel D,et al.Diagnosis of abnormal diaphragm motion after cardiothoracic surgery:ultrasound performed by a cardiac intensivist vs.fluoroscopy.Congenit Heart Dis,2010,5(6):565-572.
[30] Tsui BC,Tsui J.ABC Diaphragmatic evaluation for neonates.Paediatr Anaesth,2016,26(7):768-769.
[31] Zambon M,Greco M,Bocchino S,et al.Assessment of diaphragmatic dysfunction in the critically ill patient with ultrasound:a systematic review.Intensive Care Med,2017,43(1):29-38.