【摘要】 目的 :总结先天性膈疝 (CDH)的临床特点和诊治经验。方法 :采用病例 -对照研究的方法 ,将 2 5例 1岁以下CDH患者分为重症组和普通组 ,分析比较病儿母亲的妊娠史、产前B超检查、出生后的发病进程、围手术期处理及手术方法等资料。结果 :重症组与普通组病儿母亲妊娠史明显异常者均较少 ;重症CDH产前B超检出率比普通组高 ,病儿呼吸储备低 ,呼吸循环不稳定 ,围手术期处理困难 ,手术耐受性较差 ,病死率高。结论 :肺发育不良和肺动脉高压是先天性膈疝的主要危险因素 ;普通CDH病儿可根据情况选择择期或限期手术 ,而对重症CDH则应采取积极有效的措施 ,争取呼吸循环基本稳定后再予手术 ,可望获得较好疗效。更多还原

【Abstract】 Objective:To summarize the clinical characteristic and experience gained from treatment of congenital diaphragmatic hernia.Methods:Twenty-five patients under one year old were categorized into high-risk group and low-risk group.Pregnant history of patients’ mother,prenatal ultrasonic examination,postnatal episode procedure,management during perioperation and operative approachs were analyzed with the case-control study.Results:There were few cases with abnormal pregnant history in both groups.The prenatal ultrasonic positive rate of high-risk group was higher than that of the low-risk group.Compared with low-risk patients,high-risk patients presented lower breathing reserve,more unstable conditions of respiration and circulation,more difficult in management during perioperation,poorer tolerance for operation and higher mortality.Conclusion:Lung hypoplasia and pulmonary hypertension were the principal risk factor of congenital diaphragmatic hernia.A selective or a deadline operation can be chosen in low-risk patients according to patient’s condition.While for high-risk patients,active measures should be taken to improve the condition of the patient’s respiration and circulation first,then an operation can be performed for a satisfactory surgical outcome.更多还原