Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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Unilateral Diaphragmatic Paralysis after Thyroid Surgery

갑상선 수술 후 발생한 편측 횡격막 마비 1예

  • Byun, Jong Kyu (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Rhee, Sang Youl (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Kim, Yu Jin (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Um, Yu Jin (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Kim, Seul Ki (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Son, Jung Il (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Chin, Sang Ouk (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Chon, Suk (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Kim, Woo-Shik (Department of Cardiology, Kyung Hee University School of Medicine) ;
  • Kim, Joo Young (Department of Internal Medicine, Dongsuwon General Hospital) ;
  • Lee, Byoung Wook (Department of Internal Medicine, Dongsuwon General Hospital) ;
  • Woo, Jeong-Taek (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine) ;
  • Kim, Young Seol (Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine)
  • 변종규 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 이상열 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 김유진 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 엄유진 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 김슬기 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 손정일 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 진상욱 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 전숙 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 김우식 (경희대학교 의과대학 심장내과학교실) ;
  • 김주영 (동수원병원 내과) ;
  • 이병욱 (동수원병원 내과) ;
  • 우정택 (경희대학교 의과대학 내분비대사내과학교실) ;
  • 김영설 (경희대학교 의과대학 내분비대사내과학교실)
  • Received : 2014.07.31
  • Accepted : 2014.09.15
  • Published : 2014.10.31
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Abstract

갑상선 암 진단과 치료기술이 발전하면서 최근 그 수술 건 수가 급격하게 증가하고 있다. 하지만이와 관련된 합병증과 부작용을 면밀하게 평가해야 할 필요 역시 점차 늘어나고 있다. 갑상선 암 수술 후 발생할 수 있는 드문 합병증의 하나로 횡격막 신경마비(phrenic nerve paralysis)가 있다. 이러한 횡격막신경마비는 대부분 증상이 경미하고 쉽게 호전되어 임상적으로 크게 중요하게 다루어지지 않았다. 하지만, 갑상선 수술 후 갑작스런 호흡곤란이 발생한다면 횡격막 신경마비에 의한 횡격막 마비(diaphragmatic paralysis)와 관련되었을 가능성을 놓치지 말아야 한다. 저자들은 최근 갑상선암 수술 후 발생한 호흡곤란으로 2년 동안 심각한 호흡곤란을 호소하던 73세 여자환자에서 투시촬영(fluoroscopy) 상 편측으로 상승되고 운동성이 저하된 횡격막을 확인하여 일측성 횡격막신경마비(Unilateral phrenic nerve paralysis)를 확진 하였다. 갑상선수술 후 발생하는 일측 횡경막 신경마비는 임상에서 드물게 관찰되는 수술 합병증이기에 환자는 상당기간 이에 대한 감별이 제대로 이루어지지 않았다. 우리는 횡격막 마비의 조기 진단과 적극적인 치료를 통하여 심한 호흡곤란을 호소하는 환자의 증상 및 병의 경과를 호전 시킬 수 있었다.

Keywords

References

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