先天性膈疝产前至手术后全过程管理中的几个焦点问题  

Several critical issues in the management of congenital diaphragmatic hernia from prenatal to postoperative period

作　　者：何秋明 夏慧敏 He Qiuming;Xia Huimin(Department of Neonatal Surgery,Municipal Women&Children's Medical Center,Guangzhou Medical University,Guangzhou 510623,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心新生儿外科,广州510623

出　　处：《临床小儿外科杂志》2024年第12期1101-1105,共5页Journal of Clinical Pediatric Surgery

基　　金：广东省自然科学基金项目(2020A1515010296)。

摘　　要：先天性膈疝是常见的先天性结构畸形,可导致肺发育不良、肺动脉高压和心脏功能障碍,是引起新生儿死亡或长期并发症的常见原因。目前先天性膈疝的诊疗模式已经由单纯的外科手术治疗发展为产前-产时-围手术期-手术后全过程管理。本文就先天性膈疝产前产后全过程管理中的几个焦点问题,如产前评估与干预、分娩时管理、围手术期管理及体外膜肺氧合技术的应用、手术时机与手术方式的选择、手术后及出院后管理等,结合当前国内外研究现状进行评述。As a common congenital structural anomaly,congenital diaphragmatic hernia(CDH)may cause pulmonary hypoplasia,pulmonary hypertension and cardiac dysfunction.It has been one common cause of neonatal mortality or long-term complications.Current management model of CDH is evolving from merely surgery to prenatal-intrapartum-perioperative-postoperative integrated mode.Based upon the latest global researches,this review summarized the management of CDH,including prenatal assessment&intervention,management of delivery,perioperative management and application of extracorporeal membrane oxygenation,selection of surgical timing and approaches,postoperative care and post-discharge management.

关 键 词：疝 横膈 先天性 围手术期 诊断 外科手术 管理 进展 

分 类 号：R47[医药卫生—护理学]