Katz A L, Wiswell T E, Baumgart S
Department of Surgery, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania, USA.
Clin Perinatol. 1998 Mar;25(1):219-48.
Congenital diaphragmatic hernia (CDH) has remained the most frustrating of the major birth defects to manage successfully. Despite the earlier detection of severe diaphragmatic defects by prenatal ultrasound, and the early recognition of CDH as a cause for respiratory distress presenting at birth, current mortality has improved little from the original series presented in 1940 by Ladd and Gross. This article discusses the difficulty in defining population with congenital diaphragmatic hernia, current controversies in the medical and surgical management of these patients, appropriate timing and usage of ECMO, a review of current, experimental therapies, and short-term and long-term outcomes of these patients.
先天性膈疝（CDH）仍然是最难成功处理的主要出生缺陷之一。尽管产前超声能更早地检测出严重的膈缺陷，且能更早地识别出CDH是出生时出现呼吸窘迫的一个原因，但自1940年Ladd和Gross发表最初系列报道以来，目前的死亡率几乎没有改善。本文讨论了先天性膈疝患者群体定义的困难、这些患者在医学和外科治疗方面当前存在的争议、体外膜肺氧合（ECMO）的恰当使用时机和方法、对当前实验性治疗的综述以及这些患者的短期和长期预后。
