带有先天性心脏病的先天性隔膜,包括心室隔膜缺陷:风险因素
Yuichi Hirano1, Keita Terui1, Wataru Kudo1
1Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
概括
带有腹腔隔膜缺陷 (VSD) 的先天性腹膜 (CDH) 的预后不佳. 低肺体积是这些婴儿死亡的关键风险因素,类似于孤立的CDH病例.
科学领域:
- 儿科手术 儿科手术
- 新生儿心脏病学 新生儿心脏病学
- 医学遗传学 医学遗传学
背景情况:
- kongenital diaphragmatic hernia (CDH) 显著影响新生儿的结果,特别是当与先天性心脏病 (CHD) 相关时.
- 心室隔膜缺陷 (VSD) 是CDH病例中最常见的CHD并发症,导致预后不佳.
- 确定预后因素对于管理VSD的CDH至关重要.
研究的目的:
- 确定与VSD相关的CDH的预后因素.
- 在CDH和VSD的新生儿队列中,比较幸存者和非幸存者之间的结果.
主要方法:
- 在2000-2022年期间对新生儿CDH和CHD病例进行了一项回顾性观察研究.
- 通过比较幸存者和非幸存者来分析CDH与VSD的风险因素.
- 评估了产前诊断和肺体积指标.
主要成果:
- 在84名CDH婴儿中,有14名患有心血管疾病,11例患有VSD (79%的心血管疾病).
- 对于CDH的存活率与左侧疾病和VSD的产前诊断为56%.
- 低肺体积 (观察到/预期的肺面积与头部周长率≤35%) 在未幸存者中显著高 (75%与0%,p=0.048). 没有幸存者也患有严重的冠心病或肺高血压.
结论:
- 低肺体积是CDH与VSD的重要风险因素,影响生存率.
- 这一发现可与单个CDH病例的预后因素相比较.
- 早期识别低肺体积对于管理VSD的CDH至关重要.
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