FETAL DIAPHRAGMATIC-HERNIA - PRENATAL EVALUATION OF LUNG HYPOPLASIA AND EFFECTS OF IMMEDIATE OPERATION

被引：7

作者：

KAMATA, S

HASEGAWA, T

MATSUO, Y

FUKUZAWA, M

IMURA, K

OKADA, A

机构：

[1] Department of Pediatric Surgery, Osaka University Medical School, Osaka, 553, 1-1-50 Fukushima, Fukushima-ku

来源：

PEDIATRIC SURGERY INTERNATIONAL | 1992年 / 7卷 / 02期

关键词：

CONGENITAL DIAPHRAGMATIC HERNIA; LUNG HYPOPLASIA; FETAL ULTRASONOGRAPHY; HIGH-FREQUENCY OSCILLATION VENTILATION; EXTRACORPOREAL MEMBRANE OXYGENATION;

D O I：

10.1007/BF00183914

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

The outcome of fetuses with diaphragmatic hernia (CDH) has been reported to be related to the severity of lung hypoplasia. As an index of pulmonary hypoplasia, we attempted to measure the lung-thorax transverse area ratio (L/T) using ultrasonic echography in eight fetuses with left-sided CDH. Two cases with L/T more than 0.28 (controls: 0.52 +/- 0.04) were transported postnatally and recovered after early operation without episodes of persistent fetal circulation. Elective surgical repair was performed in six infants immediately after cesarean delivery at 35-37 weeks' gestation. In three cases with L/T between 0.21 and 0.24 who recovered with no complications, surgical reduction of the abdominal organs improved arterial blood gases and high-frequency oscillation ventilation (HFOV) was fully effective for respiratory management. In three with L/T between 0.11 and 0. 17, extracorporeal membrane oxygenation (ECMO) was required from the 1 st to the 12th postoperative day despite HFOV. Although two infants died of combined cardiovascular anomalies and airway bleeding caused by prolonged HFOV, respectively, one infant with minimal L/T survived. Measurement of L/T may help to predict the outcome of fetuses with CDH and to determine the indications for various treatments including immediate operation after cesarean delivery, HFOV, and ECMO.

引用

页码：109 / 112

页数：4

共 16 条

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