[新生儿先天性膈疝的胸腔镜修复术：47例报告]
[Thoracoscopic repair of congenital diaphragmatic hernia in neonates: a report of 47 cases].
作者信息
Wang Hefeng, Liu Xingfeng, Wang Hongxuan, Hu Yuanjun, Wu Yurui
机构信息
Department of Neonate Surgery, Qilu Children's Hospital of Shandong University, Jinan 250022, China.
Neonatal Intensive Care Unit, Qilu Hospital of Shandong University, Jinan 250012, China.
出版信息
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2018 May 25;47(3):283-288. doi: 10.3785/j.issn.1008-9292.2018.06.11.
OBJECTIVE
To review the application of thoracoscopic repair for treatment of congenital diaphragmatic hernia in neonates, so as to improve the cure rate.
METHODS
Clinical data of 47 neonates with congenital diaphragmatic hernia receiving thoracoscopic repair from June 2012 to June 2017 were reviewed. The admission age, gestational age, birth weight, timing of diagnosis, hernia location, clinical manifestation, surgical timing, surgical method, operation time, postoperative mechanical ventilation time of patients were analyzed.
RESULTS
There were 42 cases of left diaphragmatic hernia and 5 cases of right diaphragmatic hernia. Thirteen cases were diagnosed prenatally. Primary diaphragmatic repair was successfully accomplished under thoracoscope in 45 neonates without perioperative complications, while 2 patients were converted to open surgery. The average operation time was (63±13) min (42-150 min), the average blood loss was (3.0±1.7) mL (1.0-9.0 mL), and the average postoperative mechanical ventilation time was (3.9±1.4) d (2.0-11.0 d). Two patients died and the treatment was withdrawn in 3 patients with an overall cure rate of 89.4% (42/47).
CONCLUSIONS
Thoracoscopic repair is effective and can be used as first-choice treatment of diaphragmatic hernia in neonates.
目的
回顾胸腔镜修补术在新生儿先天性膈疝治疗中的应用，以提高治愈率。
方法
回顾性分析2012年6月至2017年6月间47例接受胸腔镜修补术的新生儿先天性膈疝的临床资料。分析患儿的入院年龄、胎龄、出生体重、诊断时间、疝位置、临床表现、手术时机、手术方式、手术时间、术后机械通气时间。
结果
左侧膈疝42例，右侧膈疝5例。13例产前诊断。45例新生儿在胸腔镜下成功完成一期膈疝修补术，无围手术期并发症，2例中转开腹手术。平均手术时间为(63±13)分钟(42 - 150分钟)，平均出血量为(3.0±1.7)毫升(1.0 - 9.0毫升)，平均术后机械通气时间为(3.9±1.4)天(2.0 - 11.0天)。2例死亡，3例放弃治疗，总治愈率为89.4%(42/47)。
结论
胸腔镜修补术治疗新生儿膈疝疗效确切，可作为首选治疗方法。
Zotero 插件