Han Xiao-Yue, Selesner Leigh Taryn, Butler Marilyn W
Department of Surgery, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Mail Code L223, Portland, OR 97239, USA.
Department of Surgery, Division of Pediatric Surgery, Oregon Health and Science University, 501 North Graham Street, Suite 300, Portland, OR 97227-2008, USA.
Surg Clin North Am. 2022 Oct;102(5):739-757. doi: 10.1016/j.suc.2022.07.007. Epub 2022 Sep 7.
The contemporary pillars of congenital diaphragmatic hernia (CDH) management include prenatal diagnosis for multidisciplinary care coordination and counseling, medical optimization after birth, and elective (not emergent) operative repair after stabilization, allowing for improvement in pulmonary hypertension and maturation of lungs. Lung hypoplasia and pulmonary hypertension in infants with CDH represent a medical emergency, not one that necessitates immediate surgery. Many infants surviving CDH repair have significant morbidities that may persist into adulthood. Rare cases of previously occult CDH may present acutely in the older child or adult with nonspecific gastrointestinal or pulmonary symptoms.
先天性膈疝（CDH）治疗的当代支柱包括产前诊断以协调多学科护理和咨询、出生后进行医学优化，以及在病情稳定后进行择期（而非急诊）手术修复，以改善肺动脉高压和促进肺成熟。CDH患儿的肺发育不全和肺动脉高压是一种医疗急症，而非需要立即手术的情况。许多CDH修复术后存活的婴儿有严重的疾病，这些疾病可能会持续到成年期。以前隐匿性CDH的罕见病例可能会在大龄儿童或成人中急性出现，伴有非特异性的胃肠道或肺部症状。
