Konjenital Diyafragma Hernisi: On Yıllık Tek Merkez Sonuçları

Yıl 2017, Cilt: 15 Sayı: 3, 1 - 10, 01.12.2017

Bayram Ali Dorum , Salih Çağrı Çakır Uğur Yakut Hilal Özkan Arif Nuri Gürpınar Nilgün Köksal

Öz

GİRİŞ ve
AMAÇ: Konjenital diyafragma hernisi (KDH) yüksek mortalite ve uzun dönem
morbiditeler ile ilişkili nadir bir anomalidir. Bu çalışmanın amacı ünitemizde
KDH tanısı ile takip edilen hastaların demografik, klinik özelliklerini,
uygulanan tedavi ve sonuçlarını tanımlamaktır.

YÖNTEM ve GEREÇLER: : Bu çalışmada Uludağ Üniversitesi Tıp Fakültesi yenidoğan
yoğun bakım ünitesinde KDH tanısı ile tedavi gören hastalar retrospektif olarak
taranmıştır. Ocak 2007 ile Aralık 2016 arasında ünitemizde tedavi gören hastaların
medikal kayıtları incelenmiştir. Hastaların demografik ve doğum özellikleri,
pulmoner hipertansiyon durumları, karaciğer ve mide herniasyonları, ek
konjenital anomalileri, mekanik ventilasyon şekilleri değerlendirilmiştir.

BULGULAR: : Çalışma periyodu boyunca KDH nedeniyle tedavi gören 40 hasta
çalışmaya alınmıştır. Tüm hastalar içinde ölüm oranı %67.5 (27/40) olarak
gerçekleşmiştir. Düşük doğum ağırlığı, düşük gestasyonel hafta, düşük APGAR
skorları ve başlangıçta yüksek oksijen ihtiyacı mortalite ile ilişkili
bulunmuştur. Opere edilen hastalar içinde yaşama oranı %61 (13/21) idi. Yaşayan
hastaların ortalama hastanede kalış süreleri 23 (14–35) idi. Taburculuk sonrası
komorbid durumlar kronik gastrointestinal, pulmoner sorunlar ve büyüme geriliği
olarak saptandı.

TARTIŞMA ve SONUÇ: KDH halen yüksek mortalite ve morbiditeye sahiptir. Prenatal
tanı alan hastaların uygun merkezlerde doğması başarılı müdahale şanslarını
artıracaktır. 

Congenital Diaphragmatic Hernia:
Ten-Year Single Center Results

INTRODUCTION:
Congenital diaphragmatic hernia (CDH) is a rare abnormality with high mortality
and long-term comorbid conditions. Our aim, in this paper, was to describe
demographics and birth characteristics, treatment, and outcomes of consecutive
patients with CDH treated at our institution.

METHODS: The present study represents a retrospective cohort study of neonates
with CDH who were treated at Uludag University Medical Faculty, Neonatal
intensive care unit, Bursa. We identified the medical records of all patients
with CDH who were admitted for treatment to our neonatal intensive care unit
from January 2007 to December 2016. We reviewed the medical, surgical records,
demographics and birth characteristics. We also recorded presence of pulmonary
hypertension, whether or not the liver and, stomach also herniated into the thorax,
other associated congenital malformations, and type of mechanical ventilation.

RESULTS: Forty patients were included in this study. The overall mortality was
67.5% (27/40). Survival for those who had surgical correction of CDH was 61%
(13/21). Low birth weight, low gestational age, low APGAR scores and, high
oxygen need at baseline was found to be associated with mortality, in patients
with CDH. Among survivors, the median duration of hospitalization was 23
(14–35) days. Chronic gastrointestinal, pulmonary disorders and, failure to
thrive were the most comorbid conditions after discharge.

DISCUSSION AND CONCLUSION: KDH still has high mortality and morbidity. The
birth of patients with prenatal diagnosis at appropriate centers will increase
their chances of successful intervention.

Anahtar Kelimeler

Konjenital diyafragma hernisi, pulmoner hipertansiyon, pulmoner hipoplazi, yenidoğan

Kaynakça

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