中文摘要：

目的探讨儿童先天性心脏病术后膈肌麻痹的临床表现、诊断及治疗。方法回顾性分析10 200例先天性心脏病手术后发生膈肌麻痹35例患儿的临床资料,对膈肌麻痹的典型临床表现及确诊方法进行总结,对膈肌折叠术的疗效进行评价。结果膈肌麻痹的发病率为0.34%;35例中左侧膈肌麻痹17例,右侧膈肌麻痹14例,双侧膈肌麻痹4例;脱离呼吸机通气困难35例,再次气管插管32例,呼吸机相关性肺炎29例,气管切开10例;32例行膈肌折叠术,术后均顺利脱离呼吸机辅助通气,膈肌折叠术后呼吸机使用时间较术前明显缩短（P〈0.05）;无死亡病例。结论先天性心脏病术后膈肌麻痹的发生率较低,膈肌折叠是膈肌麻痹有效的治疗手段。

英文摘要：

Objective To investigate the clinical presentations,diagnosis and therapy of diaphragmatic paralysis in children with congenital heart disease after cardiac surgery.Methods A retrospective study was performed in 35 cases of diaphragmatic paralysis from 10 200 patients with congenital heart disease receiving cardiac surgery.The causes of diaphragmatic paralysis,typical clinical presentations and methods of diagnosis were summarized.The efficacy of diaphragmatic plication was evaluated.Results The incidence of diaphragmatic paralysis was 0.34%.In these 35 cases of diaphragmatic paralysis,there were 17 cases of left diaphragm,14 cases of right diaphragm and 4 cases of bilateral diaphragm.Dyspnea occurred in 35 cases after weaning off of ventilator.And 32 cases received reintubation.Ventilator-associated pneumonia occurred in 29 cases and tracheotomy occurred in 10 cases.Diaphragmatic plication was performed in 32 cases and all of them weaned off ventilator successfully after the placation.The average duration of mechanical ventilation was significantly shorter after the diaphragmatic plication than that before the plication.No death occurred.Conclusion The incidence of diaphragmatic paralysis is low in patients with congenital heart disease after cardiac surgery.Diaphragmatic plication is an effective treament.