ABSTRACT
Objective To investigate the integrated perinatal management and prognosis of prenatally diagnosed congenital diaphragmatic hernia (CDH).Methods Clinical data of 32 cases of neonatal CDH that were diagnosed and treated in the Third Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were collected and retrospectively analyzed.All cases were classified into mild,moderate and severe groups based on prenatal lung-to-head ratio (LHR),observed to expected LHR and observed to expected total fetal lung volume.The integrated perinatal management included prenatal management (prenatal diagnosis and consultation),intrapartum management (delivery) and postnatal management (postnatal diagnosis,neonatal treatment and surgical treatment).Neonatal outcomes were analyzed.Statistical analysis was performed using Chi-square test and t-test.Results All of the 32 cases were diagnosed by prenatal ultrasonography and assessed by MRI.There were 18 mild,nine moderate and five severe CDH cases,respectively.Left-sided and right-sided CDH were respectively found in 27 and five cases.Thirty neonates underwent surgery when the diagnosis had been confirmed after birth and the conditions were stable after comprehensive treatment.The total survival rate was 81％ (26/32).The neonatal survival rates of severe and mild groups were 1/5 and 18/18,respectively.The more severe the CDH,the lower the survival rate (x2=16.538,P＜0.001).Among the 18 neonates with mild CDH,five neonates underwent minimally invasive laparoscopic surgery had shorter fasting time,duration of postoperative antibiotic administration and hospital stay than those received open surgery (n=13)[(2.4±0.5) vs (4.6±1.2) d,t=-3.939;(7.6±1.2) vs (9.8±1.4) d,t=-3.144;(14.4±1.1) vs (19.7±2.8) d,t=-4.064;all P＜0.01].Neonates who were discharged alive received a three months to two years postoperative treatment and follow-up and one received a second operation due to recurrence and all recovered.Conclusions Prognosis of neonatal CDH are closely related to prenatal conditions.Integrated management is of great significance in CDH.
ABSTRACT
OBJECTIVE:To evaluate the efficacy and safety of Xuebijing injection in the adjuvant treatment of children with perforated appendicitis. METHODS:72 children with perforated appendicitis in the Dept. of Pediatric General Surgery of our hospi-tal were enrolled into a prospective clinical trial,and randomly divided into experimental group (n=36) and control group (n=36). Both groups received the emergency surgery and anti-infective treatment;experimental group had additionally given Xuebijing injection. The white blood cell count (WBC),C-creation protein (CRP) and procalcitonin (PCT),liver and kidney function and hospitalization time before and after treatment were collected and adverse reaction. RESULTS:The WBC in experimental group af-ter 3 and 6 d of treatment was respectively(13.6±3.4)×109 L-1 and(9.1±4.2)×109 L-1,CRP was respectively(52.7±13.6)mg/L and(8.5±3.3)mg/L,the PCT(0.3±0.2)ng/ml,and the hospitalization time after 3 d were lower than control group,with signifi-cant difference(P0.05). There was 1 case with itch of skin but with no severe ADR. CONCLUSIONS:Xuebijing injection in the adjuvant treatment of children with perforated ap-pendicitis is safe and effective.