Darmaun Laura, Lejeune Stephanie, Drumez Elodie, Mur Sebastien, de Langle-Chevalier Fanny, Nève Véronique, Storme Laurent, Michaud Laurent, Gottrand Frederic, Thumerelle Caroline, Deschildre Antoine
Paediatric Pulmonology and Allergy Unit, Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, Lille, France.
Univ. Lille, CHU Lille, Reference Centre for Rare Oesophageal Diseases, U995 - LIRIC - Lille Inflammation Research International Centre, Lille, France.
Acta Paediatr. 2021 Feb;110(2):695-703. doi: 10.1111/apa.15426. Epub 2020 Jul 19.
To assess quality of life (QoL) in children with congenital diaphragmatic hernia (CDH) and to compare it with oesophageal atresia (OA).
A cross-sectional study in CDH children (≥7 years) was conducted in Lille University Hospital, France, from January 2013 to April 2014. History, lung function (rest, exercise) and Pediatric Quality of Life Inventory questionnaires (PedsQoL 4.0) were collected. Data of OA children were previously published.
Fifty-four CDH patients (male: 53%, median age: 11 years, IQR 9-14) were compared to 54 OA patients (male: 61%, median age: 13 years, IQR: 11-15). CDH children had significantly more frequent history of pneumonia (30% vs 13%), exercise limitation (54% vs 35%) and chest deformity (39% vs 11%); 46% had an obstructive pattern and 66% an abnormal cardiopulmonary exercise test. The median PedsQoL total score in children was 81 (IQR 73-90) in CDH and 81 (IQR 72-91) in OA (P = .8). In CDH, duration of neonatal oxygen therapy, hospitalisation for respiratory disease, exercise limitation, inhaled corticosteroids treatment, chest deformity, abnormal cardiopulmonary exercise test and lower forced expiratory volume in one second were significantly associated with lower QoL scores.
PedsQoL scores remained satisfactory in CDH children with CDH, with no difference compared to OA. Patients with respiratory morbidity and lung function impairment, who displayed lower scores, should be identified in order to optimise their management in reference centres.
评估先天性膈疝（CDH）患儿的生活质量（QoL），并与食管闭锁（OA）患儿进行比较。
2013年1月至2014年4月在法国里尔大学医院对CDH患儿（≥7岁）进行了一项横断面研究。收集了病史、肺功能（静息、运动）和儿童生活质量量表问卷（PedsQoL 4.0）。OA患儿的数据此前已发表。
将54例CDH患者（男性：53%，中位年龄：11岁，四分位间距9 - 14岁）与54例OA患者（男性：61%，中位年龄：13岁，四分位间距：11 - 15岁）进行比较。CDH患儿肺炎病史（30%对13%）、运动受限（54%对35%）和胸部畸形（39%对11%）更为常见；46%有阻塞型模式，66%心肺运动试验异常。CDH患儿的PedsQoL总分中位数为81（四分位间距73 - 90），OA患儿为81（四分位间距72 - 91）（P = 0.8）。在CDH患儿中，新生儿氧疗持续时间、因呼吸系统疾病住院、运动受限、吸入糖皮质激素治疗、胸部畸形、心肺运动试验异常和一秒用力呼气量降低与较低的生活质量评分显著相关。
CDH患儿的PedsQoL评分仍令人满意，与OA患儿无差异。应识别出生活质量评分较低、有呼吸系统疾病和肺功能损害的患者，以便在参考中心优化其管理。
