先天性膈疝的围手术期处理

Perioperative Management of Congenital Diaphragmatic Hernia

目的总结先天性膈疝的围手术期处理经验,以提高先天性膈疝患儿的抢救成功率和生存质量。方法回顾性分析我院2000年1月～2006年10月21例新生儿先天性膈疝患儿的围手术期处理。结果左侧膈疝18例,右侧膈疝3例。除2例高危患儿于复苏中死亡外,19例均行手术治疗。术后死亡1例,并发肠梗阻1例,气胸1例,患侧局限性膈膨升1例。治愈18例。结论早期诊断并及时地进行转运前救治,适时行膈肌修补术及术后呼吸机支持,作好围手术期的呼吸管理,有效地预防术后并发症的发生,是提高先天性膈疝治愈率的有效措施。

Objective To summarize the experience of the perioperative management of congenital diaphragmatic hernia(CDH)in neonates.Methods The clinical data from 21 cases(18 cases of left CDH,3 cases of right CDH)with CDH were reviewed.Results Nineteen patients underwent operation.After operation,intestinal obstruction happened in 1 case,pneumothorax in 1,diaphragmatic eventration in 1,died of congenital heart disease in 1.Two patients didn't undergo operation,because they died in resuscitation failure.Conclusions For improving the cure rate of CDH,the effective measures are early diagnosis,correct preadmission management,in time repair of diaphragmatic hernia and respiratory support in perioperation as wellas postoperation.