58例新生儿先天性膈疝围术期监护

发布时间：2018-03-31 11:51

本文选题：疝　切入点：横膈　出处：《重庆医学》2017年10期

【摘要】：目的总结该院6年先天性膈疝(CDH)的围术期监护经验。方法收集该院2010年1月至2016年4月共58例新生儿CDH的临床病例资料进行回顾性分析,根据患儿诊断后是否进行手术治疗,分为治疗组(39例)和放弃组(19例);根据出生后6h内是否出现呼吸窘迫症状,将治疗组分为重症A组(29例)及非重症B组(10例)。结果手术距入院时间A组(38.07±18.78)h,B组(21.10±5.46)h,ICU监护时间中位数A组5(2.00,9.50)d、B组2(1.00,2.25)d,差异均有统计学意义(P0.05);术后机械通气时间中位数A组34(19.5,42.5)h、B组23(16.5,39.5)h,平均住院时间A组(16.76±5.99)d、B组(15.40±2.17)d,差异均无统计学意义(P0.05);放弃组19例,均于入院后3d内放弃治疗,院内死亡5例。治疗组39例无一例死亡。结论 CDH是新生儿危重症之一,加强围术期监护是提高CDH生存率的关键。
[Abstract]:Objective to summarize the experience of perioperative monitoring of congenital diaphragmatic hernia in this hospital. Methods 58 cases of neonatal CDH from January 2010 to April 2016 were collected and analyzed retrospectively. According to the diagnosis, the children were divided into treatment group (39 cases) and abandonment group (19 cases), according to whether there were respiratory distress symptoms within 6 hours after birth. The treatment group was divided into severe group A (n = 29) and non-severe group B (n = 10). Results the median time of ICU monitoring in group A was 21.10 卤5.46 hours after operation and the median time between operation and admission was 21.10 卤5.46 in group B.There were significant differences in 21.002.25 days between group A and group A, the median time of mechanical ventilation after operation (P 0.05). The average hospitalization time of group A was 16.76 卤5.99 days (15.40 卤2.17 days), there was no significant difference between group B and group B (P 0.05). All of them gave up treatment within 3 days after admission and 5 died in hospital. In the treatment group, 39 cases died. Conclusion CDH is one of the critical neonates, and strengthening perioperative monitoring is the key to improve the survival rate of CDH.
【作者单位】：重庆医科大学附属儿童医院重症医学科/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室/重庆市儿童发育重大疾病诊治与预防国际科技合作基地;
【分类号】：R722

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