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新生儿出生后 6小时内出现呼吸窘迫综合征 ( RDS)的重症先天性膈疝 ,治疗比较困难 ,死亡率较高。过去对重症先天性膈疝患者须行紧急手术的观点已受到强烈质疑 ,近年来主张先通过各种治疗措施使患者呼吸循环稳定后再施行修补手术的治疗方案 ,其疗效较以前有所提高。现就一般措施、机械通气、体外膜肺、吸入性一氧化氮、激素类药物、肺泡表面活性物质、外科手术时机及其术式等方面对其治疗进行综述。
Severe congenital diaphragmatic hernia of respiratory distress syndrome (RDS) occurs within 6 hours after birth, resulting in more difficult treatment and higher mortality. In the past, patients with severe congenital diaphragmatic hernia need emergency surgery has been strongly questioned in recent years, advocated by a variety of treatment measures to make patients stable respiratory cycle before the implementation of repair surgery, the treatment effect than ever before increased. General treatment, mechanical ventilation, extracor membrane lung, inhaled nitric oxide, hormonal drugs, alveolar surfactant, timing of surgery and surgical procedures are reviewed.