Yan Wenbo,Wang Jun,Pan Weihua,et al.Clinical characteristics and efficacy comparison of congenital diaphragmatic eventration patients with left/right side lesion[J].Journal of Clinical Pediatric Surgery,,18():1057-1060,1066.[doi:10.3969/j.issn.1671-6353.2019.12.014]
Clinical characteristics and efficacy comparison of congenital diaphragmatic eventration patients with left/right side lesion
- Keywords:
- Thoracoscopy; Diaphragmatic Eventration; Prognosis; Comparative Study; Child
- CLC:
- R726;R565
- Abstract:
- Objective Congenital diaphragmatic eventration (CDE) due to diaphragmatic dysplasia may impair respiratory functions and arrest normal growth.The goal of this study was to compare the clinical characteristics and prognoses of CDE patients with left versus right-sided lesions.Methods Retrospective reviews were conducted for 43 CDE children from January 2007 to June 2017.There were 31 boys and 12 girls with an average age of 12 (2-72) months.And the involved side was right (n=35) and left (n=8).The procedures included thoracoscopic mini-invasive surgery (n=39),open transabdominal surgery (n=1),open transthoracic surgery (n=1) and laparoscopy (n=2).Basic profiles,clinical manifestations,associated malformations,height of diaphragm on chest plain film and surgical efficacy were compared. Results During an average follow-up period of 4.75(1-11) years,no significant difference existed in gender,age,birth weight,gestational age or delivery mode between left/right siders.Congenital heart diseases accounted for 20.93% (9/43) of CDE-associated malformations.And 5/8 cases were diagnosed with left-side CDE and 4/35 cases with right-side CDE.A significant difference existed between the incidence of congenital heart disease associated with left-side (62.5%) and right-side (11.43%) CDE.88% of CDE children developed respiratory symptoms and no significant difference between left/right-side CDE (P=0.18).And height of elevated diaphragm was higher at left side than at right side on chest plain film (t=3.18,P<0.01).Among 17 cases of recurrent respiratory infections,9 cases with long-duration infection had a high level of CDE.Therefore it was insufficient to confirm that height of CDE was positively correlated with severity of clinical manifestations.The average length of hospitalization stay was (13.3±5.05) days.All patients had clinical remission except for one recurrence of right-side CDE.Conclusion CDE occurs more frequently right side.Few differences exist between left/right-side CDE except that congenital heart disease is more often associated with left-side CDE and the height of elevated diaphragm is higher at left side than right side on chest plain film.However,no significant difference exists clinical symptoms or prognosis.
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Memo
收稿日期:2018-10-15。
基金项目:上海交通大学医工交叉项目（编号：YG2017MS76）
通讯作者:王俊,Email:wangjun@xinhuamed.com.cn;施诚仁,Email:Shicr629@163.com