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目的探讨先天性膈疝孕妇及新生儿临床特点,建立先天性膈疝产时处理流程规范,提高先天性膈疝患儿围产期生存率。方法回顾性分析中国医科大学附属盛京医院2008年1月至2016年12月收治的23例先天性膈疝患者临床资料。结果 23例患儿均接受子宫外产时处理(EXIT)手术,20例患儿出生后行膈肌修补术,2例患儿放弃治疗,1例患儿暂未手术。远期随访19例患儿生存,2例失访。结论轻中度先天性膈疝患儿孕期通过超声诊断后应转入产前诊断中心,密切监测并完善相关检查,分娩时多学科合作行EXIT手术,并在新生儿呼吸、循环系统功能稳定后行膈疝修补手术,能够得到良好的预后结局。
Objective To investigate the clinical features of congenital diaphragmatic hernia in pregnant women and newborns and to establish the standard of treatment for congenital diaphragmatic hernia during delivery and to improve the perinatal survival rate in children with congenital diaphragmatic hernia. Methods The clinical data of 23 patients with congenital diaphragmatic hernia admitted to Shengjing Hospital Affiliated to China Medical University from January 2008 to December 2016 were retrospectively analyzed. Results All the 23 children underwent EXIT. 20 children underwent diaphragmatic repair after birth, 2 patients gave up treatment, and 1 patient had no surgery. Long-term follow-up 19 cases of children survived, 2 cases were lost. CONCLUSIONS: Children with mild to moderate congenital diaphragmatic hernia should be transferred to the prenatal diagnosis center after their diagnosis by ultrasound during pregnancy. Closely monitor and improve the related examinations and childbirth EXIT during multi-disciplinary cooperation. After neonatal respiration and circulatory system are stable Diaphragmatic hernia repair surgery, can get a good prognosis.