Cheng Qianqian,Wu Yeming,Wang Jun,et al.Analysis of related factors affecting neonatal sputum survival rate-Comparison between open surgery and endoscopic surgery[J].Journal of Clinical Pediatric Surgery,2019,18(03):237-241.[doi:10.3969/j.issn.1671-6353.2019.03.016]
影响新生儿膈疝生存率的相关因素分析——开放手术与腔镜下手术比较
- Title:
- Analysis of related factors affecting neonatal sputum survival rate-Comparison between open surgery and endoscopic surgery
- Keywords:
- Thoracoscopes; Infant/Newborn; Hernia/Diaphragmatic; Treatment Outcome
- 分类号:
- R722.19;R616.5
- 摘要:
- 目的 对接受开放手术与腔镜手术两种不同术式的膈疝新生儿进行围手术期资料的对比，并在此基础上探讨影响新生儿膈疝生存率的风险因素。方法 回顾性分析2006年1月至2016年3月上海交通大学医学院附属新华医院收治并于该院接受手术治疗的76例新生儿膈疝患者的临床资料，按照不同术式对膈疝患儿进行分组（开放组和腔镜组），评估腔镜手术对新生儿膈疝修补的效果，并对影响预后的相关因素进行分析。结果 76例中腔镜组29例，开放组47例。因术后死亡或病情加重放弃治疗的患儿共18例（17.5%），且18例均为年龄<28 d的新生儿。腔镜组死亡率为10.3%，开放组死亡率为31.9%。新生儿膈疝的预后与产前获诊孕周、产后Apgar评分、出生体重、肺动脉高压等因素有关，与是否选择腔镜手术则无明显关系。结论 随着腔镜技术的成熟，早期提出的一些儿童膈疝腔镜手术禁忌值得重新被考虑。
- Abstract:
- Objective To explore the risk factors associated with the survival rate of congenital diaphragmatic hernia (CDH) children and the application of mini-invasive surgery.Methods The clinical data of 76 hospitalized CDH neonates undergoing surgery from January 2006 to March 2016 were retrospectively analyzed.And the relevant prognostic factors were analyzed.And open surgery and endoscopy were performed to evaluate the outcomes of endoscopic repair of neonatal CDH.Results The age was ≤ 28 days.Endoscopy (n=29) and open surgery (n=47) were performed.Postoperative death or exacerbation leading to abandoning treatment in 18 neonates (17.5%) aged under 1 month.Mortality was 10.3% and 31.9% respectively in endoscopic versus open surgery group.Comparing poor prognosis group with good prognosis group,the prognosis of CDH was correlated with prenatal diagnosis gestational age,postpartum Apgar score,birth weight and pulmonary hypertension.However,it was not correlated with the choice of endoscopic surgery.Conclusion With continuous refining of endoscopic techniques,some early surgical contraindications for CDH should be reconsidered.
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备注/Memo
收稿日期:2018-05-03。
通讯作者:吴晔明,Email:wuymsh@163.com