Li Haizhen,Ma Lishuang,Wang Ying,et al.Analysis of prognostic factors of neonatal congenital diaphragmatic hernia[J].Journal of Clinical Pediatric Surgery,,21():458-462.[doi:10.3760/cma.j.cn101785-202012069-011]
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Analysis of prognostic factors of neonatal congenital diaphragmatic hernia

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第21卷 Number: 2022 05 Page: 458-462 Column: 论著 Date of publication: 2022-05-01
Author(s):
Li Haizhen1;  Ma Lishuang2;  Wang Ying2;  Liu Chao2;  Wei Yandong2;  Yu Simiao1;  Zhao Yunlong3
1 Capital Institute of Pediatrics, Peking University Teaching Hospital, Beijing 100020, China;
2 Department of Neonatal Surgery, Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing 100020, China;
3 Depart- ment of Neonatal Surgery, Peking Union Medical College, Chinese Academy of Medical Sciences, Capital Institute of Pediatrics, Affiliated Children’s Hospital, Beijing 100020, China
Keywords:
Hernias;  Diaphragmatic;  Congenital; Root Cause Analysis; Infant;  Newborn;  Diseases; Prognosis
DOI:
10.3760/cma.j.cn101785-202012069-011
Abstract:
Objective To summarize the clinical features of neonatal congenital diaphragmatic hernia (CDH) treated at a single center over the last 6 years and explore the related factors of poor prognosis. Methods From April 2014 to July 2020, clinical data were retrospectively reviewed for 73 CDH children. According to the prognosis, they were divided into two groups of good prognosis (54 survivors) and poor prognosis (19 deaths). The clinical data of children in two groups were collected, including gender, whether or not gestational week of birth < 37 weeks, birth weight < 2. 5 kg, gestational age of diagnosis ≤ 25 weeks, surgical approach, operative duration < 24h after birth, operative duration < 180 min, liver position, hernia position, gestational week of birth and operative duration. Multivariate Logistic regression was employed for examining the related factors of poor prognosis. Results There were 46 boys and 27 girls. The involved side was left (n=58) and right (n=15). Sixty-three cases were detected through a prenatal diagnosis and 10 cases confirmed by chest radiography for postnatal respiratory distress. Fifty-four children (54/73, 73. 9%) survived and 19 (19/73, 26. 1%) died. Fifty-four children were discharged from hospital after recovery and their parents were instructed to exercise lung function. During an average follow-up period of 2. 78 years, outpatient or telephone follow-ups were performed. The survival rates of 90 d,1/2/5-year after discharge were 100%. Multivariate Logistic regres- sion indicated that low birth weight, operation within 24h after birth, open operation and diagnosis of gestational age ≤ 25 weeks were the related factors for poor prognosis (P < 0. 05). Conclusion Low birth weight, diagno- sis of gestational age ≤ 25 weeks and operation timing < 24 h may be risk factors for poor prognosis of CDH. Thoracoscopic repair may be preferred if a surgeon is experienced.

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Memo

收稿日期:2020-12-26。
基金项目:1.北京市儿科学科协同发展中心儿科专项基金资助项目（XTZD20180305）；2.国家重点研发计划基金资助项目（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（2018-TG-51）
通讯作者:马立霜,Email:malishuang2006@sina.com

Last Update: 1900-01-01