A Clinical Research On Postoperative Pulmonary Function Test Of The Congenital Diaphragmatic Hernia Patients

Objective:The aim of the study was to find out whether there is any difference of postoperative pulmonary function between the congenital diaphragmatic hernia patients and the healthy children, and to search the perioperative correlative factor for the postoperative pulmonary function results.Materials and Methods:We conducted a cross-section study to investigate the influence of the congenital diaphragmatic hernia on postoperative pulmonary function test. For those congenital diaphragmatic hernia patients who underwent a repair surgery in the Children’s Hospital of Chongqing Medical University from January 2009 to March 2016, we contacted them by phone to perform the pulmonary function test at the original hospital or a nearby grade A class 3 hospital. There were 31 cases who had successfully performed the test, among them 18 cases were between 0 to 3 years old, 13 cases above 3 years old. Meanwhile we performed the pulmonary function test on 12 healthy cases between 0 to 3 years old as the control group. Then we implemented a comparison of the pulmonary function test between the 0 to 3 years old postoperative patients and the healthy patients, and a comparison between the actual and predicted valued of the patients above 3 years old, and a correlation study to search the perioperative correlative factor for the postoperative pulmonary function results.Results:For those patients from 0 to 3 years old: postoperative RR, t PTEF%t E, VPEF%VE, PTEF as % TEF25, PTEF as %VT and the TEF50 as % TIF50 was significantly different from the control group.For those patients above 3 years old: both the actual FEV1/FVC values, actual PEF values, actual MEF75 values of the postoperative pulmonary function test results were significantly less than the corresponding predicted values, but they all lie within the normal range.C. The size of the diaphragmatic defect was correlated with the postoperative TV/Kg(r =-0.68), FVC(r = 0.60), FEV1( r = 0.55), PEF(r = 0.83), MEF75(r = 0.56), MEF50(r = 0.62), MEF25(r = 0.54), MMEF(r = 0.83), MVV(r = 0.74).Conclusions:A. Within 3 years old, postoperative pulmonary t PTEF%t E is less than the control group, this suggests an obstruction of the small airway.B. Above 3 years old, the postoperative pulmonary function test results lie within the normal range.C. The size of the diaphragmatic defect is correlated with the postoperative TV/Kg within 3 years, and correlated with the FVC, FEV1, PEF, MEF75, MEF50, MEF25, MMEF, MVV exceeding 3 years.