20例小儿膈疝的诊断与治疗

Diagnosis and surgical treatment of diaphragmatic hernia in infants and children

报道小儿膈疝２０例，其中男１３例，女７例，年龄１０ｄ～６岁，２岁以内者１６例，占８０％。先天性膈疝１７例，以心肺受压症状为主者１３例，消化道症状突出者４例。３例外伤性膈疝均有急性心肺功能不全表现。对右侧、病程长、缺损巨大的膈疝，主张经胸手术。术后死亡２例，病死率１０％（２／２０）。术后加强心肺功能的维护，应用ＨＦＪＶ可提高生存率。

Twenty patients, 13 males and 7 females . with diaphragmatic hernia were operated on from 1972 to 1993. The youngest was 10 days after birth and the oldest was 6 years,and sixteen were younger than two years of age. Seventeen patients with congenital diaphragmatic hernia and three traumatic diaphragmatic hernia. The symptoms revealed : compressing lung and heart in 13 cases, upsetting G-1 function in 4 cases. In 3 traumatic cases were acute disfunction & pulmonary and cardiac. The transpleural approach is preferable to incarcer-ated hernia or the hernia & older children, especially in the right side. Dostoperative period combined high-frequency oscillatory ventilation and extracorporeal membrane oxygenation (ECMO) can increase successful rate.