해면상 림프관종 제거수술후 발생한 횡격막 신경 마비 유아에서 횡격막 주름 성형술후 환기보조에서 이탈 성공 예 : 증례보고

Abstract

Phrenic nerve palsy is a well-known complication following cardiac surgery in children. The incidence is approximately 1~2%. In infants and young children, it often cause a life-threatening respiratory distress. They must be treated with mechanical ventilation in the ICU. Many patients with phrenic nerve injury who is impossible to wean from a ventilator are candidates of diaphragmatic plication. Diaphragmatic plication is performed to restore the normal pulmonary parenchymal volume by replacing the diaphragm to its proper location. This is a case of 2-months-old infant who had phrenic nerve palsy after the removal of cavernous lymphangioma of the chest. He underwent 4 operations to remove the mass and to have pericardiotomy. We tried to wean him from the ventilator but failed several times in the ICU. After 4th operation, right diaphragmatic elevation was noted from the chest X ray. Phrenic nerve palsy was confirmed with fluoroscopy and he underwent diaphragmatic plication on 42 days after his 4th operation. Three days after the diaphragmatic plication, weaning was successfully carried out.