Grethel Erich J, Nobuhara Kerilyn K
Fetal Treatment Center, Department of Surgery, University of California, San Francisco, 94143, USA.
J Paediatr Child Health. 2006 Mar;42(3):79-85. doi: 10.1111/j.1440-1754.2006.00802.x.
Congenital diaphragmatic hernia (CDH) continues to account for significant mortality in neonates. Advances in postnatal therapies have reduced mortality rates in the less severely affected infants, though surviving infants continue to display significant comorbid conditions. The history of fetal treatment for CDH is a microcosm for the development of fetal therapy in general. This paper traces this history from early clinical observations and imaging advances to experimental animal studies and finally to safe human application and development of clinical trails. Encouraging recent results and improved outcomes lend credence to the idea than prenatal interventions may give clinicians and families more hope.
先天性膈疝（CDH）仍然是新生儿死亡的重要原因。尽管病情较轻的婴儿经产后治疗后死亡率有所下降，但存活下来的婴儿仍有显著的合并症。一般来说，CDH胎儿治疗的历史是胎儿治疗发展的一个缩影。本文追溯了这段历史，从早期的临床观察和影像学进展到实验动物研究，最终到安全的人体应用和临床试验的发展。近期令人鼓舞的结果和改善的预后使产前干预可能给临床医生和家庭带来更多希望这一观点更具可信度。
