新生儿先天性膈疝诊治的回顾性分析
DOI:
CSTR:
作者:
作者单位:

作者简介:

通讯作者:

中图分类号:

基金项目:


Retrospective analysis of neonatal congenital diaphragmatic hernia
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:总结我院13年新生儿先天性膈疝(congenital diaphragmatic hernia,CDH)的诊治经验。方法:收集我院2000年1月至2013年10月共85例CDH的临床病例资料及术前、术后血气结果进行回顾性研究。结果:85例CDH的病人中有男性57例,女性28例;左侧膈肌缺失82例,右侧膈肌缺失3例。主要临床表现为吐奶、呼吸急促、口唇发绀,患侧叩诊为鼓音,偶可闻肠鸣音。胸片可见胸腔囊状气泡,未见膈面显示,纵膈及心影明显移位;消化道碘油造影未见膈面,胸腔见肠管显影。82例患儿经腹、3例经胸行膈疝修补,术后其症状、体征、影像学检查及术后3 d动脉血pH、PCO2、PO2均恢复至正常[pH、PCO2、PO2值术前分别为:(7.29±0.05)、(7.06±0.16)、(9.70±0.28) kPa,术后3 d分别为(7.38±0.03)、(4.87±0.15)、(11.91±0.21) kPa,分别比较后,P均<0.05],无死亡病例。结论:新生儿膈疝诊断明确后应积极术前准备,经膈疝修补术后患儿的症状、体征、影像学检查及血气分析均能恢复正常。

    Abstract:

    Objective:To summarize the experiences of diagnosis and treatment of neonatal congenital diaphragmatic hernia(CDH) in our hospital in thirteen years. Methods:The clinical data and preoperative and postoperative blood gas data of 85 CDH cases from January 2000 to October 2013 were collected and retrospectively analyzed. Results:Totally 57 male patients and 28 female patients were enrolled including 83 cases of left diaphragmatic deletion and 2 cases of right diaphragmatic deletion. Main clinical symptoms were vomit,breathlessness and cyanosis. Percussion was performed and bowel sound was heard occasionally in sick side. Cystic bubbles were observed in the thoracic cavity but were disappeared in facies diaphragmatica and were shifted in mediastinum and heart shadow in thoracic radiograph. Facies diaphragmatica was disappeared and intestinal canal was found the thoracic cavity by iodipin opacifi-cation. Diaphragm of 82 cases was repaired through the abdomen and diaphragm of 3 cases was repaired through the thoracic cavity. On 3 d after the operation,symptoms,signs,imaging studies and pH,PCO2,PO2 in arterial blood of all patients were recovered[(pH,PCO2,PO2 values were (7.29±0.05),(7.06±0.16),(9.70±0.28) kPa respectively before the operation and were (7.38±0.03),(4.87±0.15),(11.91±0.21) kPa respectively after on 3 d after the operation,P<0.05)]. Moreover,there was no dead case of neonatal congenital diaphragmatic hernia in our hospital. Conclusion:Patients should be prepared actively before the operation when CDH is comfirmed. The symptoms,signs,imaging studies and blood gas analysis of the patients can return to normal after repair of diaphrag-matic hernia.

    参考文献
    相似文献
    引证文献
引用本文

代江涛,吴 春,潘征夏,李洪波,王 刚,李勇刚,安 永.新生儿先天性膈疝诊治的回顾性分析[J].重庆医科大学学报,2014,38(9):1264-1267

复制
分享
相关视频

文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2014-12-03
  • 出版日期:
文章二维码