Yu Simiao,Ma Lishuang,Wang Ying,et al.Prenatal evaluations and postnatal diagnosis and treatment of congenital diaphragmatic hernia[J].Journal of Clinical Pediatric Surgery,,19():441-446.[doi:10.3969/j.issn.1671-6353.2020.05.013]
Prenatal evaluations and postnatal diagnosis and treatment of congenital diaphragmatic hernia
- Keywords:
- Hernia; Diaphragmatic/CN; Thoracoscopy; Therapy; Survival Rate; Infant; Newborn
- CLC:
- R726;R655.6
- Abstract:
- Objective Congenital diaphragmatic hernia (CDH) refers to a structural birth defect of diaphragmatic defect.We performed a retrospective analysis and summarized the experiences of thoracoscopy for neonatal diaphragmatic hernia.Methods All children received prenatal consultations at the departments of obstetrics and pediatrics.Neonatal surgeons waited for delivery in delivery room.The children were transferred into SNICU of our center through a green channel of critical newborn transport.The departments of neonatal surgery and ultrasound,NICU,cardiac surgery and other disciplines formulated treatment plans.Thoracoscopy was preferred.After operation,neonatal surgeons continued perioperative treatment in NICU.Results From April 2014 to July 2019,there were 42 thoracoscopic cases of neonatal diaphragmatic hernia.35 children survived and 7 died.6 cases were converted into open surgery.2 cases survived and another 2 died.Among 13 cases of open repairing,5 survived and 8 died.And 3 cases of CDH were prenatally diagnosed and died preoperatively.The mean postnatal operative time was (30±16) hours,the mean postoperative time of invasive ventilator (5±2) days and the mean hospital stay (21±13) days.After discharge,follow-ups were conducted at outpatient service or by telephone for 1 to 60 months.After pulmonary function exercises,respiratory functions recovered well. The development and activity levels were similar to those of normal same-age children.Conclusion Thoracoscopic surgery is safe and feasible in neonatal CDH treatment. Prenatal diagnosis time,operation timing, operation mode are important indicators to predict the prognosis of children.
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Memo
收稿日期:2019-05-28。
基金项目:北京市儿科学科协同发展中心儿科专项基金资助项目（编号：XTZD20180305）；国家重点研发计划基金资助项目（编号：2018YFC1002503）；3.北京市卫生与健康科技成果和适宜技术推广项目基金资助项目（编号：2018-TG-51）
通讯作者:马立霜,Email:malishuang2006@sina.com