Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (2): 191-194.doi: 10.24920/003648

• 病例报告 • 上一篇    



  1. 中国医学科学院 北京协和医学院 北京协和医院 麻醉科 北京,100730 中国
  • 收稿日期:2019-08-06 接受日期:2019-12-30 出版日期:2020-06-30 发布日期:2020-06-16
  • 通讯作者: 黄宇光

Phrenic Nerve Injury Is a Differential Diagnosis of Hypoxemia after Video-Assisted Thoracoscopic Thymectomy: 2 Cases Report and Literature Review

Ma Lulu,Huang Yuguang()   

  1. Department of anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2019-08-06 Accepted:2019-12-30 Published:2020-06-30 Online:2020-06-16
  • Contact: Huang Yuguang


全麻术后低氧血症并不少见。 对于胸科手术患者而言,低氧血症的鉴别诊断比较困难。手术、麻醉和患者相关的因素均会导致术后低氧血症。本文描述了两例视频辅助胸腔镜胸腺瘤切除术的患者,拔管后即刻出现低氧血症,两位患者均怀疑发生了膈神经损伤。一例未经干预,膈神经功能恢复。另一例最终证实为双侧膈神经损伤,经过物理治疗和呼吸功能锻炼2个月后仍未脱离呼吸机支持。

关键词: 膈神经损伤, 低氧血症, 视频辅助胸腔镜手术


Hypoxemia after general anesthesia is not uncommon. For patients after thoracotomy, the differential diagnosis is usually difficult. Surgical, anesthetic, and patient-associated factors may contribute to postoperative hypoxemia. We described two patients who underwent video-assisted thoracoscopic thymectomy and developed hypoxemia immediately after extubation. Phrenic nerve injury was suspected in both patients. One case recovered spontaneously without intervention. The second case who had been demonstrated as bilateral phrenic nerve injury after the operation was continuously on ventilator after physical therapy and respiratory training for 2 months.

Key words: Phrenic nerve injury, hypoxemia, video-assisted thoracoscopic surgery

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