[1]吴嘉丽,胡 阳,李英华,等.超声评估膈肌功能的方法及其在临床中的应用[J].医学信息,2023,36(16):174-178.[doi:10.3969/j.issn.1006-1959.2023.16.036]
　WU Jia-li,HU Yang,LI Ying-hua,et al.The Method of Ultrasonic Evaluation of Diaphragmatic Function and its Clinical Application[J].Journal of Medical Information,2023,36(16):174-178.[doi:10.3969/j.issn.1006-1959.2023.16.036]
点击复制

超声评估膈肌功能的方法及其在临床中的应用()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年16期
页码:
174-178
栏目:
综述
出版日期:
2023-08-15

文章信息/Info

Title:
The Method of Ultrasonic Evaluation of Diaphragmatic Function and its Clinical Application
文章编号:
1006-1959（2023）16-0174-05
作者:
吴嘉丽; 胡 阳; 李英华; 等
（昆明医科大学附属延安医院全科医学科1，超声医学科2，云南 昆明 650000）
Author(s):
WU Jia-li; HU Yang; LI Ying-hua; et al.
(Department of General Medicine1,Department of Ultrasound Medicine2,Yan’an Hospital Affiliated to Kunming Medical University,Kunming 650000,Yunnan,China)
关键词:
超声; 膈肌功能; 呼吸功能; 慢性阻塞性肺病; 慢性心衰
Keywords:
Ultrasound; Diaphragm function; Respiratory function; Chronic obstructive pulmonary disease; Chronic heart failure
分类号:
R445
DOI:
10.3969/j.issn.1006-1959.2023.16.036
文献标志码:
A
摘要:
膈肌是重要的呼吸肌之一，膈肌功能异常可明显影响呼吸功能。目前临床可使用超声动态观察膈肌厚度、膈肌移动度等指标，并通过公式计算膈肌厚度分数、膈肌收缩速度等指标综合评估患者膈肌功能。临床中评估臂丛神经阻滞伴随的膈肌功能障碍、慢性阻塞性肺病的肺功能及运动耐量、重症患者及麻醉后患者的撤机拔管时机及早期发现慢性心衰患者的吸气肌无力和运动耐量下降等可对患者的病情及治疗疗效提供动态监测并能够实现早期干预甚至改善预后。本文主要就超声评估膈肌功能的相关指标及其测量方法、膈肌超声在临床中的应用等进行综述。
Abstract:
Diaphragm is one of the important respiratory muscles. Abnormal diaphragm function can obviously affect respiratory function. At present, ultrasound can be used to dynamically observe the diaphragm thickness, diaphragm excursion and other indicators, and calculate the diaphragm thickness fraction, diaphragmatic velocity and other indicators by formula to comprehensively evaluate the diaphragm function. Clinical evaluation of diaphragmatic dysfunction associated with brachial plexus block, lung function and exercise tolerance of chronic obstructive pulmonary disease, timing of weaning and extubation of critically ill patients and patients after anesthesia, and early detection of inspiratory muscle weakness and decreased exercise tolerance in patients with chronic heart failure can provide dynamic monitoring of the patient’s condition and treatment efficacy, and can achieve early intervention and even improve prognosis. This article mainly reviews the related indicators and measurement methods of ultrasound evaluation of diaphragmatic function, and the clinical application of diaphragmatic ultrasound.

参考文献/References:

[1]Ricoy J,Rodriguez-Nunez N,Alvarez-Dobano JM,et al.Diaphragmatic dysfunction[J].Pulmonology,2019,25(4):223-235.[2]安小凤,王兆,吴丹.超声下膈肌移动幅度对全麻苏醒期拔管的指导意义[J].浙江实用医学,2020,25(2):115-116.[3]王飞飞,朱晓萍,马少林.超声评估膈肌结构和功能[J].中华危重病急救医学,2017,29(3):276-280.[4]Sarwal A,Walker FO,Cartwright MS.Neuromuscular ultrasound for evaluation of the diaphragm[J].Muscle&Nerve,2013,47(3):319-329.[5]Goligher EC,Laghi F,Detsky ME,et al.Measuring diaphragm thickness with ultrasound in mechanically ventilated patients: feasibility, reproducibility and validity[J].Intensive Care Med,2015,41(4):642-649.[6]黄佳茹.超声评估正常人群膈肌功能的研究[D].银川:宁夏医科大学,2016.[7]Gottesman E,McCool FD.Ultrasound evaluation of the paralyzed diaphragm[J].Am J Respir Crit Care Med,1997,155(5):1570-1574.[8]Boussuges A,Gole Y,Blanc P.Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values[J].Chest,2009,135(2):391-400.[9]Schulz A,Erbuth A,Boyko M,et al.Comparison of Ultrasound Measurements for Diaphragmatic Mobility, Diaphragmatic Thickness, and Diaphragm Thickening Fraction with Each Other and with Lung Function in Patients with Chronic Obstructive Pulmonary Disease[J].Int J Chron Obstruct Pulmon Dis,2022,17:2217-2227.[10]马瑛,叶熊,胡利华,等.超声测量膈肌运动诊断慢性阻塞性肺疾病[J].中国医学影像技术,2018,34(1):64-67.[11]Tounsi B,Acheche A,Lelard T,et al.Effects of specific inspiratory muscle training combined with whole-body endurance training program on balance in COPD patients: Randomized controlled trial[J].PLoS One,2021,16(9):e257595.[12]Paulin E,Yamaguti WP,Chammas MC,et al.Influence of diaphragmatic mobility on exercise tolerance and dyspnea in patients with COPD[J].Respir Med,2007,101(10):2113-2118.[13]Shiraishi M,Higashimoto Y,Sugiya R,et al.Diaphragmatic excursion correlates with exercise capacity and dynamic hyperinflation in COPD patients[J].ERJ Open Res,2020,6(4):00589-2020.[14]Shiraishi M,Higashimoto Y,Sugiya R,et al.Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease[J].Respir Res,2021,22(1):271.[15]Spiesshoefer J,Boentert M,Tuleta I,et al.Diaphragm Involvement in Heart Failure: Mere Consequence of Hypoperfusion or Mediated by HF-Related Pro-inflammatory Cytokine Storms?[J].Frontiers in physiology,2019,10:1335.[16]van Hees HW,van der Heijden HF,Hafmans T,et al.Impaired isotonic contractility and structural abnormalities in the diaphragm of congestive heart failure rats[J].Int J Cardiol,2008,128(3):326-335.[17]Nakagawa NK,Diz MA,Kawauchi TS,et al.Risk Factors for Inspiratory Muscle Weakness in Chronic Heart Failure[J].Respir Care,2020,65(4):507-516.[18]Kinugasa Y,Miyagi M,Sota T,et al.Dynapenia and diaphragm muscle dysfunction in patients with heart failure[J].European Journal of Preventive Cardiology,2018,25(16):1785-1786.[19]周盼盼,张乐英,周亮,等.膈肌功能障碍对心力衰竭患者肺功能和运动耐力的影响[J].浙江中西医结合杂志,2020,30(1):33-35.[20]Chua TP,Anker SD,Harrington D,et al.Inspiratory muscle strength is a determinant of maximum oxygen consumption in chronic heart failure[J].Br Heart J,1995,74(4):381-385.[21]Miyagi M,Kinugasa Y,Sota T,et al. Diaphragm Muscle Dysfunction in Patients With Heart Failure[J].J Card Fail,2018,24(4):209-216.[22]Spiesshoefer J,Henke C,Kabitz HJ,et al.Heart Failure Results in Inspiratory Muscle Dysfunction Irrespective of Left Ventricular Ejection Fraction[J].Respiration,2021,100(2):96-108.[23]Jorbendaze A,Young R,Shaburishvili T,et al.Synchronized diaphragmatic stimulation for heart failure using the VisONE system: a first-in-patient study[J].ESC Heart Fail,2022,9(4):2207-2214.[24]胡焕盛,黄娟娟,安小凤,等.不同浓度罗哌卡因行肌间沟臂丛阻滞对膈神经传导的影响[J].浙江医学,2018,40(20):2287-2290.[25]殷琴琴,许强,陈有园,等.两种容量罗哌卡因用于超声引导下肌间沟臂丛神经阻滞对膈肌麻痹的影响[J].临床麻醉学杂志,2019,35(12):1170-1173.[26]Mahmoodpoor A,Fouladi S,Ramouz A,et al.Diaphragm ultrasound to predict weaning outcome: systematic review and meta-analysis[J].Anaesthesiol Intensive Ther,2022,54(2):164-174.[27]McCool FD,Oyieng’o DO,Koo P.The Utility of Diaphragm Ultrasound in Reducing Time to Extubation[J].Lung,2020,198(3):499-505.[28]Lang JX,Yi J.Feasibility of Perioperative Diaphragmatic Ultrasound in Assessment of Residual Neuromuscular Blockade[J].Acta Academiae Medicinae Sinicae,2021,43(2):205-210.

相似文献/References:

[1]姚玉琳,王小红,覃开凤.大动脉转位的产前超声诊断评价[J].医学信息,2018,31(05):153.[doi:10.3969/j.issn.1006-1959.2018.05.055]
　YAO Yu-lin,WANG Xiao-hong,QIN Kai-feng.Prenatal Ultrasound Diagnosis of Transposition of Great Arteries[J].Journal of Medical Information,2018,31(16):153.[doi:10.3969/j.issn.1006-1959.2018.05.055]
[2]翟 蓓,周 洋,周 薇,等.超声检查、磁共振及血清CA125测定诊断 子宫腺肌病的临床评价[J].医学信息,2018,31(11):154.[doi:10.3969/j.issn.1006-1959.2018.11.050]
　ZHAI Bei,ZHOU Yang,ZHOU Wei,et al.Clinical Evaluation of Ultrasonography,Magnetic Resonance Imaging and Serum CA125 in Diagnosis of Adenomyosis[J].Journal of Medical Information,2018,31(16):154.[doi:10.3969/j.issn.1006-1959.2018.11.050]
[3]王文平,吕小勇.常规超声对乳腺X线单纯微钙化病灶的诊断价值[J].医学信息,2018,31(12):6.[doi:10.3969/j.issn.1006-1959.2018.12.002]
　WANG Wen-ping,LV Xiao-yong.Diagnostic Value of Conventional Ultrasound for Breast X Ray Simple Microcalcification Lesions[J].Journal of Medical Information,2018,31(16):6.[doi:10.3969/j.issn.1006-1959.2018.12.002]
[4]夏 斌,陈 剑.甲状腺影像报告和数据系统的发展及临床应用[J].医学信息,2018,31(12):43.[doi:10.3969/j.issn.1006-1959.2018.12.014]
　XIA Bin,CHEN Jian.Development and Clinical Application of Thyroid Imaging Reporting and Data System[J].Journal of Medical Information,2018,31(16):43.[doi:10.3969/j.issn.1006-1959.2018.12.014]
[5]张 玉,唐 静,董虹美.超声检测早孕期卵黄囊的临床意义[J].医学信息,2018,31(18):22.[doi:10.3969/j.issn.1006-1959.2018.18.009]
　ZHANG Yu,TANG Jing,Dong Hong-mei.Clinical Significance of Detecting Yolk Sac in Early Pregnancy by Ultrasonography[J].Journal of Medical Information,2018,31(16):22.[doi:10.3969/j.issn.1006-1959.2018.18.009]
[6]尹淑红,王淑云.乳腺纤维腺病的超声分析[J].医学信息,2018,31(18):157.[doi:10.3969/j.issn.1006-1959.2018.18.051]
　YIN Shu-hong,WANG Shu-yun.Ultrasound Analysis of Fibroadenosis of Breast[J].Journal of Medical Information,2018,31(16):157.[doi:10.3969/j.issn.1006-1959.2018.18.051]
[7]楼浩男,张 矛,刘 洪.超声引导下泡沫硬化治疗小隐静脉曲张的临床疗效分析[J].医学信息,2018,31(18):182.[doi:10.3969/j.issn.1006-1959.2018.18.060]
　LOU Hao-nan,ZHANG Mao,LIU Hong.Clinical Analysis of Ultrasound-guided Foam Sclerotherapy for Small Saphenous Vein[J].Journal of Medical Information,2018,31(16):182.[doi:10.3969/j.issn.1006-1959.2018.18.060]
[8]龚英姿,吴建华.乳腺超声检查中BI-RADS分级诊断标准对乳腺原位癌的诊断价值[J].医学信息,2018,31(19):161.[doi:10.3969/j.issn.1006-1959.2018.19.050]
　GONG Ying-zi,WU Jian-hua.Diagnostic Value of BI-RADS Grading Diagnostic Criteria for Breast Carcinoma in Situ in Breast Ultrasound[J].Journal of Medical Information,2018,31(16):161.[doi:10.3969/j.issn.1006-1959.2018.19.050]
[9]欧德福.超声评价老年心血管病患者颈动脉粥样硬化的价值[J].医学信息,2018,31(23):158.[doi:10.3969/j.issn.1006-1959.2018.23.046]
　Ou De-fu.Cardiovascular Disease[J].Journal of Medical Information,2018,31(16):158.[doi:10.3969/j.issn.1006-1959.2018.23.046]
[10]陆 倩.肾上腺占位性病变的超声与CT诊断的对比[J].医学信息,2019,32(05):170.[doi:10.3969/j.issn.1006-1959.2019.05.056]
　LU Qian.Comparison of Ultrasound and CT Diagnosis of Adrenal occupying Lesions[J].Journal of Medical Information,2019,32(16):170.[doi:10.3969/j.issn.1006-1959.2019.05.056]

更新日期/Last Update: 1900-01-01