儿童先天性膈疝的诊治体会

The Diagnosis and Surgical Treatment of Congential Diaphragmatic Hernia in Infants

[目的]探讨儿童先天性膈疝的诊断方法和外科治疗效果.[方法]回顾性分析近15年来收治的11例儿童先天性膈疝病例,通过X线吞钡动态透视确诊.食管狭窄采用纵切横缝治疗,并将膈肌切口折叠交叉缝合于食管前后,做成人工膈肌角.另采用Belsey方法行His角成形,防止术后食物反流.[结果]本组无死亡病例,均痊愈出院.术后随访1～5年无其他并发症.[结论]动态下行X线钡餐,对诊断儿童先天性膈疝有决定性帮助.手术是治疗食管狭窄及膈疝所引起呕吐的惟一方法.His角成形对防止术后远期食物反流有良好的作用.

[Objective]To review the experience in diagnosis and surgical treatment of congenital diaphragmaic hemia. [Methods]Retrospective study was carried out on 11 infants with congenital diaphragmatic hernia admitted over the last 15 years. The diagnosis of this condition was confirmed by swallowing barium fluoroscopy. The esophageal stenosis was treated by longitudinal incision and transverse suture,The edges of the diaphragm incision were crossly folded and sutured . Belsey＇s procedure was performed to prevent postoperative gastroesophageal reflux. [Results]There was no postoperative death. All 11 patients survived 1 - 5years after operation without any complications. [Conclusion]In congenital short esophagus complicated with diaphragmatic hernia, barium meal is a helpful method for diagnosis. Surgery is the only method to relieve symptoms. Esophgeal hiatus and His angle plasty play an important role in proventing postoperative gastroesophageal reflux.