Effect of multidisciplinary treatment on outcomes in infants with congenital diaphragmatic hernia: 10-year experience

Q4 Medicine
Weihua Pan, Weipeng Wang, Jun Wang, Wei Xie, Yi Wang, Yinchao Jiang
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引用次数: 0

Abstract

Objective To summarize our experiences of multidisciplinary treatment (MDT) for infants with congenital diaphragmatic hernia (CDH) and explore its effect on outcomes. Methods The medical records were retrospectively reviewed for 152 CDH infants from January 2001 to December 2018. The relevant clinical data included gestational age at diagnosis and delivery, Apgar score, types of hernia, birth weight, site of liver, admission arterial blood gas analysis, types of surgery, duration of mechanical ventilation and length of hospital stay. They were divided into two groups of non-MDT from January 2001 to February 2008 (n=8) and MDT from March 2008 to December 2018 (n=144). Their clinical parameters were compared and analyzed. Results There were 80 boys and 72 girls. And the involved side was left (n=120) and right (n=32). A total of 135 children were operated. In non-MDT group, all patients underwent open surgery. In MDT group, 17 patients died of cardiorespiratory failure without surgery. Among 127 surgical infants, open (n=66) and mini-invasive (n=78) operations were performed. Compared with counterparts in non-MDT group, those infants in MDT group were more likely to delay in surgical timing [(4.8±2.3) vs. (1.1±0.4) days], higher utilization of thoracoscopy (0 vs. 48.0%) and a higher survival rate (75.0% vs. 37.5%)(all P<0.05). However, no inter-group differences existed in gender, birth weight, site/size of defect, types of surgery or prenatal diagnosis. Conclusions MDT provides an feasible and effective model for diagnosing and treating CDH with better outcomes. Key words: Hernia, diaphragmatic; Multidisciplinary treatment; Treatment model; Prognosis
多学科治疗对婴儿先天性膈疝预后的影响:10年经验
目的总结婴幼儿先天性膈疝(CDH)多学科综合治疗的经验,探讨其对预后的影响。方法回顾性分析2001年1月至2018年12月收治的152例CDH患儿的病历。相关临床资料包括诊断和分娩时的胎龄、Apgar评分、疝类型、出生体重、肝脏部位、入院动脉血气分析、手术类型、机械通气时间和住院时间。患者分为2001年1月至2008年2月非MDT组(n=8)和2008年3月至2018年12月MDT组(n=144)。比较分析两组患者的临床参数。结果男生80例,女生72例。受累侧分别为左侧(n=120)和右侧(n=32)。共有135名儿童接受手术。非mdt组均行开放手术。MDT组17例患者因心肺功能衰竭死亡,未行手术治疗。在127例手术婴儿中,进行了开放手术(66例)和微创手术(78例)。与非MDT组相比,MDT组患儿延迟手术时间的可能性更大[(4.8±2.3)天比(1.1±0.4)天],胸腔镜使用率更高(0比48.0%),生存率更高(75.0%比37.5%)(均P<0.05)。然而,在性别、出生体重、缺陷部位/大小、手术类型或产前诊断方面,组间无差异。结论MDT为CDH的诊断和治疗提供了一种可行、有效的模式,治疗效果较好。关键词:疝;膈肌;多学科治疗;处理模型;预后
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来源期刊
中华小儿外科杂志
中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.40
自引率
0.00%
发文量
8707
期刊介绍: Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.
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