论文部分内容阅读
目的探讨影响先天性膈疝(CDH)患儿生存率的危险因素。方法青岛市第八人民医院产科1995年10月至2010年09月15年间分娩临床资料完整的CDH患儿11例,回顾性分析出生胎龄、母体分娩方式、诊断时机、患儿染色体核型、膈疝发生的部位、合并的其他结构畸形、是否有肝突出、纵膈移位等因素。结果 11例CDH中单纯CDH 6例,染色体核型异常CDH 3例,伴相关结构畸形者4例(其中2例同时伴染色体核型异常)。左侧膈疝8例,右侧膈疝3例。产前诊断1例,其余均产后诊断或死亡后尸检诊断。患儿的总体病死率为81.8%。其中围产儿死亡率72.7%(8/11),新生儿晚期死亡率9.1%(1/11),幸存率18.2%(2/11)。结论 CDH患儿病死率很高。右侧膈疝、肝突出、纵膈移位等可能是单纯性CDH预后不良的危险因素。CDH合并相关结构畸形和染色体核型异常者预后不良。加强产前诊断中高危因素的评估有望提高CDH幸存率。
Objective To investigate the risk factors of survival in children with congenital diaphragmatic hernia (CDH). Methods Eighth People’s Hospital of Qingdao City, from October 1995 to September 2010 15 cases of complete clinical data of children with CDH in 11 cases, a retrospective analysis of gestational age, maternal mode of delivery, timing of diagnosis, children with karyotype, The site of diaphragmatic hernia, other structural deformities combined, whether there is prominent liver, mediastinal displacement and other factors. Results Of the 11 CDH cases, only CDH was found in 6 cases, chromosomal aberration CDH in 3 cases and associated structural abnormalities in 4 cases (2 cases with chromosomal abnormalities). Left diaphragmatic hernia in 8 cases, right diaphragmatic hernia in 3 cases. Prenatal diagnosis in 1 case, the rest were postpartum diagnosis or autopsy diagnosis after death. The overall child mortality rate was 81.8%. Perinatal mortality was 72.7% (8/11), late neonatal mortality was 9.1% (1/11) and the survival rate was 18.2% (2/11). Conclusion CDH children with high mortality. Right diaphragmatic hernia, prominent liver, mediastinal displacement may be a simple risk factor for poor prognosis of CDH. CDH merger related structural abnormalities and abnormal chromosome karyotype prognosis is poor. Assessing risk factors for prenatal diagnosis is expected to improve CDH survival rates.