新生儿先天性膈疝诊治的回顾性分析重庆医科大学附属儿童医院心胸.DOCVIP

PAGE PAGE 7 新生儿先天性膈疝诊治的回顾性分析 （重庆医科大学附属儿童医院心胸外科，重庆 400014） 代江涛 吴 春 潘征夏 李洪波 王 刚 李勇刚 安 永 【摘要】目的：总结我院11年新生儿先天性膈疝(Congenital Diaphragmatic Hernia，CDH)的诊治经验。方法：收集我院2000年1月-2011年5月共53例CDH的临床病例资料及术前、术后血气结果进行回顾性研究。结果：男性39例多于女性14例病例，51例发生于膈肌左侧，2例发生在右侧，起病的主要临床表现为吐奶、呼吸急促、口唇发绀，患侧叩诊为鼓音，偶可闻肠鸣音，胸片可见左胸腔囊状气泡，未见左膈面显示，纵膈及心影向右明显移位，消化道碘油造影未见左膈面，左侧胸腔见肠管显影。53例患儿经腹行膈疝修补术后其症状、体征及动脉血pH、PCO2、PO2均很快恢复正常，且无病儿死亡。结论：新生儿膈疝以呕吐、呼吸道症状起病，经胸片及消化道碘油造影可明确诊断，积极术前准备后尽早行膈疝修补术可取得较好的预后。 【关键词】膈疝；新生儿；回顾性分析 Retrospective analysis in diagnosis and treatment of congenital diaphragmatic hernia in neonates （Department of Pediatric Heart-thoracic Surgery, the Children’s Hospital, Chongqing Medical University） Dai Jiangtao, et a1 【Abstract】Objective：To summarize the experience in diagnosis and treatment of neonatal congenital diaphragmatic hernia(CDH) in our hospital in eleven years. Methods：We analysis retrospectively total 53 data of clinical information and preoperative postoperative blood gas analysis，which were collected from Jan,2000 to May, 2011. Results：39 Male was more than 14 female neonate, 51 cases are left, 2 cases are right，main clinical appearance are disgorging, breathlessness, cyanochroia; Tymp was detected and bowel sound was listened in sick side; there were ascidial air bladder in left cavitas thoracis, disappeared in left facies diaphragmatica, shift in 作者单位: 400014 重庆 重庆医科大学附属儿童医院心胸外科 通讯作者: 吴 春, E-mail: wuchun007@ diaphragma and arcula cordis in sternite. Left diaphragmatic surface was disappeared and intestinal canal was found in left cavitas thoracis during iodipin opacification. After repair of diaphragmatic herna through abdomen, clinical appearance and pH, PCO2, PO2 in arterial blood of all were quick recovery, moreover, there was no dead cases in our hospital for neonatal congenital diaphragmatic hernia. Conclusions：The symptom of respiratory passage and disgorging was first appearance in CDH, sternite and iodipin opacification is helpful to diagnosis of CDH. It has better result