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一个世纪前已有人做过电刺激膈神经进行负压呼吸的实验。但把它应用于临床却是1950年 Sarnoff 第一次用于小儿麻痹患者。以后陆续报道了体表刺激法和经静脉刺激法等。但是随着持续性刺激,肌收缩力逐渐下降,因此只能短时间应用。1969年 Glenn 等经多方面改良,发明了植入体内的高频诱导型膈肌起搏法以来,目前正广泛应用于临床。原理单一地电刺激膈肌只产生嗝逆样收缩,不能引起有效的换气。这一点不同于符合全或无法则的心肌收缩。为此一次电刺激需要30个以上的连续刺激波。目前,市场上出售的起搏装置(Avery 社制)是高频诱导型。刺激发生装置是采用发生单向电流的渐增型单相刺激波。通过体外天线向皮下接收器发出高频波。本装置的体外部分小型便于携带。适应证适用于中枢性肺胞低张换气综合征,脑干、脊髓等中枢性病变所致的呼吸麻痹,夜间呼吸困难综合征和顽固性嗝逆。并且,目前正用于肺切除术后及开胸
A century ago, someone had done a negative stimulation of phrenic nerve breathing experiments. However, its application to clinical but it is the first time in 1950 Sarnoff for polio patients. After one after another reported body surface stimulation and intravenous stimulation and so on. However, with sustained stimulation, muscle contractility gradually decreased, it can only be a short period of application. In 1969, Glenn and many other improvements, invented implanted in vivo high frequency induced diaphragm pacing method, is now widely used in clinical. Principle Single electrical stimulation of the diaphragm produces only a hiccups reverse contraction, can not cause effective ventilation. This is different from the whole or not consistent with myocardial contraction. For this purpose an electrical stimulation requires more than 30 consecutive stimuli waves. At present, commercially available pacing devices (manufactured by Avery) are high-frequency inducible types. Stimulation device is the use of incremental one-way current occurs single-phase stimulation wave. High-frequency waves are emitted to the subcutaneous receiver through the external antenna. The external part of the device is small and easy to carry. Indications for central pulmonary hypopnea syndrome, brain stem, spinal cord and other central paralysis caused by respiratory paralysis, nocturnal dyspnea syndrome and intractable hiccup inverse. And, is currently used for pneumonectomy and thoracotomy