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Risk factors affecting postoperative pulmonary function in congenital diaphragmatic hernia

Annals of Surgical Treatment and Research 2020년 98권 4호 p.206 ~ 213
 ( Wang Qianqian ) - Shanghai Jiao Tong University School of Medicine Xinhua Hospital Department of Pediatric Surgery

 ( Liu Quanhua ) - Shanghai Jiao Tong University School of Medicine Xinhua Hospital Department of Pediatric Respiration
 ( Zang Jingyu ) - Shanghai Jiao Tong University School of Medicine Xinhua Hospital Department of Pediatric Surgery
 ( Wang Jun ) - Shanghai Jiao Tong University School of Medicine Xinhua Hospital Department of Pediatric Surgery
 ( Chen Jie ) - Shanghai Jiao Tong University School of Medicine Xinhua Hospital Department of Pediatric Surgery

Abstract


Purpose: It is well known that congenital diaphragmatic hernia (CDH) in infants impacts pulmonary function rehabilitation after surgery. However, the risk factors of postoperative pulmonary function are still unclear. In this research, we analyzed the potential risk factors of postoperative pulmonary function in CDH patients in order to improve the clinical management of CDH patients.

Methods: Thirty-three cases CDH infants followed were enrolled from November 2016 to September 2018. Clinical data were reviewed. Tidal breathing pulmonary function testing was performed after surgery. Correlation between pulmonary function and clinical characteristics was evaluated using multivariate analysis of variance.

Results: Pulmonary dysfunction was detected in 87.9% patients (29 of 33). The defect size was found to be significantly larger in patients with obstructed and mixed ventilatory disorders (P = 0.001). Diagnosis of gestational age (GA) was also significantly earlier compared to restrictive ventilatory disorders (P = 0.001). Larger defect size, and earlier prenatal diagnosis of GA were detected in severe obstructive ventilatory disorders (P = 0.007, P = 0.001, retrospectively).

Conclusion: Most patients had various degrees of pulmonary dysfunction after surgery. Patients with larger defect size and earlier diagnosis time might be vulnerable to severe obstructive and mixed ventilatory disorders.

키워드

Airway obstruction; Infant; Tidal volume
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