目的 探讨经胸径路手术治疗小儿膈疝的临床效果。 方法 总结2010年8月至2016年10月本院收治的9例经胸径路手术治疗的膈疝患儿临床资料。 结果 9例患儿中,左侧8例,右侧1例,均采用经胸径路完成手术。手术时间(85.5±19.1)min; 术中出血量(5.1±0.3)mL,术后留置胸腔引流管(8.6±0.5)d,平均住院时间(18.2±3.0)d。所有患儿随访1～12个月,均恢复良好,X线片无异常,无一例复发。 结论 经胸径路手术治疗小儿膈疝,术中可获得满意的手术视野和操作空间,便于处理合并胸腔内畸形等较复杂CDH患儿,膈肌修补确切牢靠,对腹腔干扰小,且术后恢复时间较短,复发率低。结合相关辅助治疗手段,更有助于降低CDH患儿病死率,提高患儿生活质量。
Objective To explore the surgical efficacies of congenitiasl diaphragmatic hernia(CDH)via thoracic routes. Methods From August 2010 to October 2016,the clinical data were reviewed for 9 surgical cases of diaphragmatic hernia via thoracic routes. Results The involved sides were left(n=8)and right(n=1).The mean operative duration was 85.5±19.1 min, mean intraoperative blood loss 5.1±0.3 ml,mean postoperative length of indwelling thoracic drainage tube 8.6±0.5 day and mean hospitalization time18.2±3.0 days.During a follow-up period of 1-12 months, all cases recovered well and there was no radiological abnormality or recurrence. Conclusion With satisfactory operative field and maneuvering space,thoracic approach surgery is efficacious for diaphragmatic hernia.Its postoperative recovery time is short and recurrence rate low.Development of related auxiliary treatment helps to reduce the mortality and improve the quality of life of CDH patients.
