呼吸支持在新生儿先天性膈疝手术后的应用

Application of Breath Support in Postoperative Period of Congenital Diaphragmatic Hernia in Neonates

【目的】探讨新生儿先天性膈疝（CDH）手术后呼吸支持管理经验，以期提高CDH新生儿的抢救成功率。【方法】回顾性分析2007年6月至2010年12月本院收治的18例新生儿CDH手术病例，以同期收治的非新生儿11例CDH为对照组，对比分析手术后两组呼吸支持需要率以及呼吸支持时间。【结果】新生儿CDH组18例术后呼吸支持全部需要呼吸支持，非新生儿组11例术后4例需要呼吸支持，两组呼吸支持需要率比较，差异有统计学意义（P〈0．05）。新生几组呼吸支持时间为（106．25±27．04）h，较非新生儿组（8．38±2．26）h明显延长，差异有统计学意义（P〈O．05）。【结论】与非新生儿相比，新生儿术后可能更加需要呼吸支持。细致的围手术期处理有助于提高治疗效果。

[Objective]To explore the experience of clinical management of postoperative breath support for neonates with congenital diaphragmatic hernia（CDH） in order to improve the survival rate in neonates. [Methods] The clinical data of 18 neonates with CDH received operation in the period of June 2007 to Dec. 2010 were analyzed retrospectively. Eleven non-neonates with CDH were served as control group. The rates of requiring breath support and time course were compared between the two groups. [Results] There were 18 neonates requiring breath support in neonate CHD group and 11 neonates requiring breath support in non-neonate group, and there was significant difference in the rates of requiring breath support between two groups（ P 〈0. 05）. The support course in neonate group was （106.25±27.04）h which was obviously longer than that in non-neonate group[（8.38 ± 2.26）hi, and there was significant difference between two group（ P 〈0.05）. [Conclusion] Compared with non-neonates, neonates are prone to require postoperative breath support. Meticulous perioperative management for CDH patients can improve the treatment effect.