Ma Lishuang,Meng Chuyi.Progress in diagnosis and treatment of neonatal congenital diaphragmatic hernia[J].Journal of Clinical Pediatric Surgery,,20():801-807.[doi:10.12260/lcxewkzz.2021.09.001]
Progress in diagnosis and treatment of neonatal congenital diaphragmatic hernia
- Keywords:
- Congenital diaphragmatic hernia; Lung development; Fetal intervention; Extracorporeal membrane oxygenation
- CLC:
- R655.6;R722.1
- Abstract:
- Congenital diaphragmatic hernia (CDH) is a diaphragmatic defect resulting in herniation of abdominal contents, e.g.liver and gastric alveoli, into the chest cavity.It can lead to varying degrees of pulmonary dysplasia and pulmonary hypertension (PH).With the advances in prenatal screening, diagnosis, and identification and evaluation of prognostic factors, the treatment of CDH has been constantly improved.The comprehensive management strategies of postnatal lung protective ventilation, nutritional support, infection prevention, early active management of PH, and minimally invasive surgery to repair diaphragmatic muscle defects have also significantly improved the prognosis of CDH.Fetal endoscopic tracheal obstruction(FETO) and other fetal interventions are undergoing clinical trials internationally, showing great potential for the treatment of CDH.Though extracorporeal membrane oxygenation (ECMO) is widely used for children with severe CDH, it has a barely optimistic long-term prognosis and lacks standardized description of application timing.Additionally, the long-term management and prognosis of CDH require multi-disciplinary participation, monitoring and risk stratification based guidance.This article provides a comprehensive review of the progress in CDH’s pathophysiology, prenatal diagnosis, fetal intervention and optimal postpartum management.
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Memo
收稿日期:2021-07-05。
基金项目:国家重点研发计划（编号：2018YFC1002503）；北京市卫生与健康科技成果与适宜技术推广项目（编号：BHTPP202005）；北京市儿科学科协同发展中心儿科重点专项（编号：XTZD20180305）
通讯作者:马立霜,Email:malishuang2006@sina.com