接受体外膜肺氧合治疗的婴儿先天性膈疝手术时机：一项荟萃分析。
The timing of surgery for congenital diaphragmatic hernia in infants receiving extracorporeal membrane oxygenation: a meta-analysis.
作者信息
Lin Minhua, Wu Hao, Liao Jiachi, Lyu Ziyin, Li Le
机构信息
Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China.
出版信息
Pediatr Surg Int. 2025 Aug 5;41(1):245. doi: 10.1007/s00383-025-06146-z.
There is controversy regarding the timing of congenital diaphragmatic hernia surgery in infants receiving extracorporeal membrane oxygenation (ECMO). We conducted a meta-analysis of trials examining the optimal timing of surgery for congenital diaphragmatic hernia (CDH) in infants receiving ECMO. Compared to late surgery with ECMO, early repair surgery with ECMO reduced mortality (OR, 0.51; 95% CI 0.30-0.87; P = 0.01) and postoperative bleeding rates (OR, 0.25; 95% CI 0.11-0.54; P = 0.0004) and shortened ECMO duration (MD, - 2.15; 95% Cl, - 3.20 to - 1.09; P < 0.0001) and duration of hospitalization (MD, - 29.07; 95% Cl, - 44.55 to - 12.59; P = 0.0005). There were no significant differences in ventilator duration (MD, - 15.98; 95% CI, - 35.76 to 3.80; P = 0.11). For infants with CDH receiving ECMO, we recommend early repair surgery. Levels of evidence: Level III.
对于接受体外膜肺氧合（ECMO）治疗的婴儿先天性膈疝手术时机存在争议。我们对研究接受ECMO治疗的婴儿先天性膈疝（CDH）最佳手术时机的试验进行了荟萃分析。与ECMO辅助下的延迟手术相比，ECMO辅助下的早期修复手术降低了死亡率（OR，0.51；95%CI 0.30 - 0.87；P = 0.01）和术后出血率（OR，0.25；95%CI 0.11 - 0.54；P = 0.0004），并缩短了ECMO持续时间（MD，-2.15；95%Cl，-3.20至-1.09；P < 0.0001）和住院时间（MD，-29.07；95%Cl，-44.55至-12.59；P = 0.0005）。呼吸机使用时间无显著差异（MD，-15.98；95%CI，-35.76至3.80；P = 0.11）。对于接受ECMO治疗的CDH婴儿，我们建议早期修复手术。证据级别：III级。
Zotero 插件