新生儿及婴幼儿胸腹裂孔疝诊治的临床特点

目的 总结先天性胸腹裂孔疝的临床特点及诊治经验，以提高治愈率及成活患儿的生活质量。方法 回顾分析1983年8月～2004年6月诊治的25例先天性胸腹裂孔疝。1998年4月以前诊治8例，其中新生儿5例，婴幼儿3例；1998年4月-2004年6月诊治17例，其中新生儿10例，婴幼儿7例。左侧22例，右侧3例。行手术治疗24例，另1例未及手术即死亡。结果 1998年4月以前诊治的8例，术后7例成活，并获随访1年3个月～11年，无任何呼吸道症状，生长发育良好；死亡1例系早产儿，入院时出现紫绀、呼吸衰竭，尸检发现其肺体积甚小。1998年4月～2004年6月诊治的17例，术后15例成活，2例新生儿死于呼吸衰竭。结论 新生儿患儿呼吸困难出现越早，病情越严重；婴幼儿病情相对稳定。及时规范的处理可提高治愈率，延期手术应视患儿具体情况而定。

CLINICAL CHARACTERISTICS OF BOCHDALEK HERNIA IN NEONATES AND INFANTS

Objective To summarize the clinical characteristics,diagnosis and treatment of Bochdalek hernia in neonates and infants.Methods The data of 15 neonates and 10 infants with Bochdalek hernia,undergoing the normal diagnosis and surgical repair from August 1983 to June 2004,were retrospectively reviewed.Location was left in 22 cases and right in 3 cases.Twenty-four cases were treated by operation and 1 case died of respiratory failure before operation.Results Before April 1998,7 of 8(5 neonates,3 infants)cases of Bochdalek hernia stayed healthy and respiratory symptom-free 1 year after operation;they were followed up 1 year and 3 months to 11 years.One premature neonate with Bochdalek hernia died of respiratory failure before operation,and his lung volume was found to be dysplasia.From April 1998 to June 2004,15(8 neonates,7 infants)of 17(10 neonates,7 infants)cases of Bochdalek hernia survived postoperatively,while 2 neonates died of respiratory failure.Conclusion The earlier dyspnoea of neonates of Bochdalek hernia occur,the worse their healthy status appear.The standard and timely surgical repairs could improve the curative ratio.Whether the operation was suspended depended on the healthy states of babies.