| Japanese |
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| Title | 心臓血管外科手術後に反回神経麻痺をきたした3症例 |
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| Subtitle | 症例 |
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| Authors | 川人伸次, 北畑洋, 木村英之, 神山有史 |
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| Organization | 徳島大学医学部麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 17 |
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| Number | 4 |
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| Page | 594-597 |
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| Year/Month | 1996/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」心臓血管外科手術後に高度な反回神経麻痺をきたした3症例を経験した. 症例1は冠動脈再建術, 症例2は大動脈弁置換術, 症例3は弓部大動脈再建術を施行された患者であった. いずれの症例も特に異常なく手術を終了したが, 術後嗄声, 誤嚥を訴え耳鼻科受診し, 間接喉頭鏡所見にて左声帯の固定を認め反回神経麻痺と診断された. 本症例においては手術操作や気管内挿管などの因子に加えて, 経食道心エコーのプローブによる圧迫, 体外循環に伴う局所の低灌流や低体温の影響も反回神経麻痺の原因と考えられた. 「はじめに」術後反回神経麻痺については以前より数多くの報告があり, 多くは手術操作による直接的損傷と気管内挿管による間接的損傷が原因とされる1〜11). 今回は, 心臓血管外科手術後に高度な反回神経麻痺をきたした3症例を経験したので報告する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Recurrent laryngeal nerve palsy, Cardiovascular surgery, Tracheal intubation, Transesophageal echocardiography, Cardiopulmonary bypass |
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| English |
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| Title | Severe Recurrent Laryngeal Nerve Palsy after Cardiovascular Surgery |
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| Subtitle | |
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| Authors | Shinji Kawahito, Hiroshi Kitahata, Hideyuki Kimura, Arifumi Kohyama |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology, Tokushima University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 17 |
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| Number | 4 |
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| Page | 594-597 |
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| Year/Month | 1996/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We describe three cases of severe recurrent laryngeal nerve palsy occurring after cardiovascular surgery. The first patient was scheduled for coronary artery bypass graft, the second patient was for aortic valve replacement, the third for aortic arch replacement. In all cases, the intraoperative course was uneventful. But, after surgery, the patients complained severe hoarseness and/or aspiration. The immobility of the left vocal cord was pointed out in these patients with laryngoscopy by an otorhinopharyngolaryngologist, and postoperative recurrent laryngeal nerve palsy was diagnosed. Generally, the direct damage due to surgical manipulation and the indirect damage due to tracheal intubation are considered as the cause of postoperative recurrent laryngeal nerve palsy. In our cases, oppression by a probe of transesophageal echocardiography, and/or regional ischemia and hypothermia with cardiopulmonary bypass may contribute to the occurrence of recurrent laryngeal nerve palsy in addition to above mentioned causes. (Circ Cont 17：594〜597, 1996) |
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| Practice | Basic medicine |
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| Keywords | Recurrent laryngeal nerve palsy, Cardiovascular surgery, Tracheal intubation, Transesophageal echocardiography, Cardiopulmonary bypass |
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