Wischermann A, Holschneider A M, Hübner U
Division of Pediatric Surgery, Children's Hospital of Cologne, Germany.
Eur J Pediatr Surg. 1995 Feb;5(1):13-8. doi: 10.1055/s-2008-1066154.
From 1962 to 1988, 147 neonates were admitted for operative repair of CDH to the Division of Pediatric Surgery in the Children's Hospital of Cologne. Follow-up studies were performed on 45 patients ages 1 to 25 years representing 54.2% of the 83 survivors. 18 patients (40%) were entirely without any complaints, 11 patients (24.4%) had increased rates of respiratory infections. Especially in early childhood they suffered from obstructive alterations in the respiratory tract. No restrictive pulmonary changes were observed. Scintigraphic ventilation tests were performed on 44 cases. 34 (77%) tests indicated absolutely normal results. Some rare local deficits of lung ventilation were based on adhesive anatomic alterations of the thoracic skeleton and the diaphragm. The lung function tests conducted in 29 persons ages 6 to 25 years revealed that the vital capacity and the forced expiratory volume were all normal. We found an increase of the intrathoracic gas volume in 11 infants (disposition to pulmonary inflation). In 9 cases we observed a decrease in the mid expiratory flow curves and in 6 patients we measured an increase in the specific resistance of airways (tendency towards obstructive airway alterations). Nevertheless even former hypoplastic lungs revealed a good extensibility.
1962年至1988年期间，147例新生儿因先天性膈疝接受手术修复，入住科隆儿童医院小儿外科。对45例年龄在1至25岁的患者进行了随访研究，占83名幸存者的54.2%。18例患者（40%）完全没有任何不适，11例患者（24.4%）呼吸道感染率增加。特别是在幼儿期，他们患有呼吸道阻塞性改变。未观察到限制性肺改变。对44例患者进行了放射性核素通气试验。34例（77%）试验结果完全正常。一些罕见的局部肺通气不足是由于胸廓骨骼和膈肌的粘连性解剖改变所致。对29例年龄在6至25岁的患者进行的肺功能测试显示，肺活量和用力呼气量均正常。我们发现11例婴儿胸腔内气体量增加（有肺膨胀倾向）。9例患者呼气中期流速曲线下降，6例患者气道比阻力增加（有气道阻塞性改变倾向）。然而，即使是以前发育不全的肺也显示出良好的延展性。
