| Objective:To summarize the clinical characteristics and experience in the diagnosis and treatment of neonatal congenital diaphragmatic hernia (CDH),investigate the timing of surgery, the risk factors of prognosis and the clinical countermeasures for neonatal CDH in order to enhance its level of diagnosis and treatment, reduce the mortality and improve the prognosis.Methods:Aanalyzing the clinical data of 26 patients with neonatal CDH retrospectively, which included its clinical manifestations, diagnostic approaches, perioperative countermeasures and surgical treatment. Patients were divided into severe group and normal group according to whether there were respiratory distress syndrome 6h after birth, and compared the clinical outcomes between groups with different surgical timing. Patients also were divided into survival group and death group according to their prognosis, and analyzed the factors which may affect the prognosis. Data were analyzed by SPSS 19.0 statistical software whether there was statistical difference between groups.Results:The overall operation cure rate and mortality of 26 cases of neonatal CDH was 82%(18/22) and 31% (8/26) respectively. Among the severe group of 17 cases, the operation cure rate was 69% (9/13), mortality was 47% (8/17), which included 22% (2/9) mortality of delayed surgery,50% (2/4) of emergency surgery and 100% (4/4) of the non-surgical patients. In ordinary group of 9 cases, the operation cure rate was 100% both in emergency surgery and delayed surgery patients. And there were obvious differences (P< 0.05) between the children patients of survival group and death group in their PH value of arterial blood gas, oxygenation index and whether they needed mechanical ventilation, merged malformation and existed pulmonary hypertension and pulmonary hypoplasia or not when they were admitted to hospital.Conclusion:1.Most newborn CDH patients were at high risk critical state with high mortality.2.X-ray plain film was the most simple and practical method of postpartum diagnosis for neonatal CDH.3.The revision surgical was the fundamental way for the treatment of neonatal CDH, and children with severe CDH should be positive and effective perioperative treated before surgery. 4.Merging deformity, acidosis, significantly lower oxygenation index, having pulmonary hypertension and obvious pulmonary hypoplasia and demanding mechanical ventilation high at admission were the main risk factors affecting the prognosis of this disease. |
