Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study

作者全名："Fang, Yu; Wu, Jun; Zhang, Maolin; Yang, Yang; Yao, Lijun; Liu, Lu; Luo, Jun; Li, Linjun; Zhang, Cheng; Qin, Zhiming"

作者地址："[Fang, Yu; Wu, Jun; Zhang, Maolin; Yang, Yang; Yao, Lijun; Liu, Lu; Luo, Jun; Li, Linjun; Zhang, Cheng; Qin, Zhiming] Chongqing Med Univ, Dept Thorac & Cardiovasc Surg, Affiliated Hosp 1, Chongqing, Peoples R China; [Qin, Zhiming] Chongqing Med Univ, Dept Thorac & Cardiovasc Surg, Affiliated Hosp 1, 1 Friendship Rd,Yu Zhong Dist, Chongqing 400016, Peoples R China"

通信作者："Qin, ZM (通讯作者)，Chongqing Med Univ, Dept Thorac & Cardiovasc Surg, Affiliated Hosp 1, 1 Friendship Rd,Yu Zhong Dist, Chongqing 400016, Peoples R China."

来源：MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001066271200042

JCR分区：Q2

影响因子：1.3

年份：2023

卷号：102

期号：36

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结束页：　

文献类型：Article

关键词：case series study; diaphragmatic dysfunction; massive mediastinal tumor; respiratory dysfunction; ventilator support

摘要："Rationale:Cases of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor have rarely been studied in detail. Diaphragmatic dysfunction in such cases can lead to potentially fatal respiratory and circulatory disturbances. Therefore, timely diagnosis and intervention are important. Conservative rehabilitation therapy is the first choice for respiratory dysfunction due to diaphragmatic dysfunction.Patient concerns, Diagnoses and Interventions:We present 3 patients with respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. The diagnostic methods and therapeutic procedures for diaphragmatic dysfunction for each patient are described in detail. This study highlights the role of ventilator support combined with physical therapy in the treatment of respiratory dysfunction in such cases. The diagnosis of diaphragmatic dysfunction as well as the risk assessment of phrenic nerve involvement are also discussed. The modalities of ventilator support, including modes and parameters, are listed.Outcomes and Lessons:This study provides experiences of diagnosis and treatment of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. Timely diagnosis of diaphragmatic dysfunction primarily relies on clinical manifestations and radiography. Conservative rehabilitation therapy can improve or restore diaphragmatic function in majority of patients, and avert or delay the need for surgical intervention. Preoperative assessment of the risk of phrenic nerve involvement is important in such cases."

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