Congenital eventration of the diaphragm in children: 25 years' experience in three pediatric surgery centers.
Congenital eventration of the diaphragm in children: 25 years' experience in three pediatric surgery centers.
复制标题
儿童先天性膈肌膨出：三个小儿外科中心 25 年的经验。
DOI：
10.1055/s-2003-43573
复制
发表时间：
2003
影响因子：
1.8
通讯作者：
O. Mutaf
中科院分区：
文献类型：
--
作者：
M. Yazıcı;I. Karaca;A. Arıkan;V. Erikçi;B. Etensel;G. Temir;A. Şencan;Z. Ural;O. Mutaf
横膈膜外翻通常被定义为横膈膜叶片全部或部分不正常的抬高，但其他部分是完整的。先前的研究表明，外翻是一种相对罕见的疾病，可能是有症状的，需要手术治疗。我们的目的是评估我们的膈肌外翻患者，并根据相关文献讨论他们的特点。我们回顾性分析患者的年龄、性别、发生率、外翻部位、症状、相关异常、手术技术、并发症和生存率。1974年至1999年期间，在埃格大学、SSK儿童医院和behet Uz儿童医院的儿科外科治疗了33名患者，其中18名是男孩，15名是女孩。患者的年龄从3天到12岁不等。所有患者均出现咳嗽、呼吸窘迫、发热等呼吸道症状中的至少一种；3名新生儿因严重呼吸窘迫入院，而属于较高年龄组的儿童有急性或复发性肺部感染症状和发育不良。右侧脱位22例，左侧脱位11例。诊断是在一些放射学研究的帮助下进行的，如透视检查、上消化道系统的对比研究、胸部的直接x线片、CT扫描和超声检查（必要时）。20例患者行开胸手术，12例患者行剖腹手术。1例患者行胸腹手术。术后早期因心肺并发症死亡2例，其余存活至每年随访。综上所述，横膈膜膨出是一种最终可能致命的重要疾病。早期诊断是必要的，应用是治疗的选择。
Eventration of the diaphragm is generally defined as an abnormal elevation of all or a portion of an attenuated but otherwise intact diaphragmatic leaf. Previous studies have indicated that eventration is a relatively rare condition, which can be symptomatic and requires surgery. We aimed to evaluate our patients with diaphragmatic eventration, and to discuss their characteristics in the light of the relevant literature. We retrospectively analyzed age, sex, incidence, location of the eventration, symptoms, associated anomalies, surgical technique, complications and survival in our patients. Between 1974 and 1999, 33 patients were treated in the Pediatric Surgery Departments of Ege University, SSK Children's Hospital and Behçet Uz Children's Hospital, 18 of them boys and 15 girls. The ages of our patients ranged from three days to 12 years. All of the patients had at least one of the respiratory symptoms such as cough, respiratory distress and fever; 3 newborns were admitted with severe respiratory distress while children belonging to higher age groups had symptoms of acute or recurrent pulmonary infections and failure to thrive. The eventration was right-sided in 22, 11 eventrations were left-sided. Diagnosis was performed with the help of a number of radiological studies such as fluoroscopic investigation, contrast study of the upper gastrointestinal system, direct X-ray graphies of the thorax, CT scan and ultrasonography, as necessary. Surgery was performed via thoracotomy in 20 patients and the 12 other patients underwent laparotomy for plication. One patient underwent thoracoabdominal plication. Two patients died because of cardio-respiratory complications in the early postoperative period and the rest of them survived to annual follow-ups. In conclusion, diaphragmatic eventration is an important condition which can eventually be mortal. Early diagnosis is necessary and plication is the treatment of choice.