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首页> 美国卫生研究院文献>Korean Journal of Anesthesiology >Successful weaning from mechanical ventilation in the quadriplegia patient with C2 spinal cord injury undergoing C2-4 spine laminoplasty -A case report-
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Successful weaning from mechanical ventilation in the quadriplegia patient with C2 spinal cord injury undergoing C2-4 spine laminoplasty -A case report-

机译：四肢瘫痪伴C2-4椎板隆突成形术的C2脊髓损伤患者成功地从机械通气中撤机-病例报告-

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In patients with cervical spine injuries, respiratory function requires careful attention. Voluntary respiratory control is usually possible with lesions below C4 level although paralysis of the abdominal musculature results in a decreased ability to cough and to clear secretions, which may later lead to respiratory insufficiency. Therefore, injuries above C5 usually necessitate long term mechanical ventilation. Even though weaning criteria are not definitive for the quadriplegic patient, M-mode ultrasonography of the diaphragm may be useful in identifying patients at high risk of difficulty weaning. Diaphragmatic dysfunction (vertical excursion < 10 mm or paradoxical movements) results in frequent early and delayed weaning failures. We present our clinical experience with successful weaning by using M-mode ultrasonography and a cough-assist device for secretion clearance after extubation in a quadriplegic patient undergoing C2-4 spine laminoplasty.
机译：在颈椎损伤患者中，呼吸功能需要仔细注意。尽管腹部肌肉组织麻痹会导致咳嗽和清除分泌物的能力下降，但通常会在低于C4水平的情况下进行自愿呼吸控制，这可能会导致呼吸功能不全。因此，高于C5的伤害通常需要长期的机械通气。即使对于四肢瘫痪的患者而言，断奶标准不是确定的，但横M膜的M型超声检查可能有助于确定高难度断奶风险的患者。 ph肌功能障碍（垂直偏移<10 mm或自相矛盾的运动）导致频繁的早期和延迟的断奶失败。我们通过使用M型超声检查和在C2-4脊柱椎体成形术的四肢瘫痪患者拔管后用于清除分泌物的咳嗽辅助设备来成功断奶，介绍我们的临床经验。

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