Retrospective analysis of neonatal congenital diaphragmatic hernia

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.