新生儿先天性膈疝预后相关因素分析.

Objective To summarize the clinical features of neonatal congenital diaphragmatic hernia ( CDH) treated at a single center over the last 6 years and explore the related factors of poor prognosis. Methods From April 2014 to July 2020, clinical data were retrospectively reviewed for 73 CDH children. According to the prognosis, they were divided into two groups of good prognosis ( 54 survivors) and poor prognosis ( 19 deaths) . The clinical data of children in two groups were collected, including gender, whether or not gestational week of birth < 37 weeks, birth weight < 2. 5 kg, gestational age of diagnosis ::::; 25 weeks, surgical approach, operative duration < 24h after birth, operative duration < 180 min, liver position, hernia position, gestational week of birth and operative duration. Multivariate Logistic regression was employed for examining the related factors of poor prognosis. Results There were 46 boys and 27 girls. The involved side was left ( n = 58) and right ( n = 15). Sixty-three cases were detected through a prenatal diagnosis and 10 cases confirmed by chest radiography for postnatal respiratory distress. Fifty-four children ( 54/ 73, 73. 9%) survived and 19 ( 19/ 73, 26. 1 % ) died. Fifty-four children were discharged from hospital after recovery and their parents were instructed to exercise lung function. During an average follow-up period of 2. 78 years, outpatient or telephone follow-ups were performed. The survival rates of 90 d, 112/ 5-year after discharge were 100%. Multivariate Logistic regression indicated that low birth weight, operation within 24h after birth, open operation and diagnosis of gestational age ~25 weeks were the related factors for poor prognosis ( P < 0. 05). Conclusion Low birth weight, diagnosis of gestational age 25 weeks and operation timing <24 h may be risk factors for poor prognosis of CDH. Thoracoscopic repair may be preferred if a surgeon is experienced. [ABSTRACT FROM AUTHOR]