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目的探讨先天性膈疝(CDH)围手术期处理,以期提高CDH患儿生存率。方法回顾性分析2004年5月-2008年12月本院收治的确诊CDH的17例病例。比较其中新生儿与非新生儿患儿电解质平衡、酸碱平衡紊乱的发生率,取二组手术病例对比手术后呼吸支持需要率以及呼吸支持时间。应用SPSS10.0软件进行统计学分析。结果新生儿组酸碱平衡紊乱的发生率明显高于非新生儿组(100.0%vs37.5%,χ2=6.561,P<0.05)。术后,新生儿组呼吸支持需要率明显高于非新生儿组(100.0%vs28.6%,χ2=5.238,P<0.05),新生儿组呼吸支持时间(222.75h)较非新生儿组(8.50h)明显延长。结论新生儿与非新生儿相比,手术前酸碱平衡紊乱较明显,术后可能更加需要呼吸支持。细致的围手术期处理有助于提高治疗效果。
Objective To investigate the perioperative management of congenital diaphragmatic hernia (CDH) in order to improve the survival rate of children with CDH. Methods A retrospective analysis of 17 cases of CDH diagnosed in our hospital from May 2004 to December 2008 was performed. The incidence of electrolyte balance and acid-base balance disorder in neonates and non-neonates were compared. The required respiratory support rate and respiratory support time were compared between the two groups. Application SPSS10.0 software for statistical analysis. Results The incidence of acid-base disturbance was significantly higher in neonates than in non-neonates (100.0% vs37.5%, χ2 = 6.561, P <0.05). Postoperative neonatal respiratory support needs was significantly higher than non-neonatal (100.0% vs28.6%, χ2 = 5.238, P <0.05), neonatal respiratory support time (222.75h) than non-neonatal 8.50h) significantly prolonged. Conclusions Compared with non-newborns, the disturbance of acid-base balance before surgery is more obvious, and postoperative respiratory support may be more needed. Careful perioperative treatment can help improve the treatment effect.