CAJ | 학술논문

目的：总结迟发型膈疝患儿的临床表现，讨论影响手术期限选择的因素。方法收集2006年1月至2013年6月，西安市儿童医院收治迟发型膈疝患儿47例，对其年龄、症状、体征、辅助检查、合并疾病、术中所见肺发育情况、手术期限等资料进行回顾性分析。结果以呼吸系统症状为主要表现就诊者25例，占53％。以消化系统症状就诊者14例，占30％。平素无症状，体检发现者8例。胸片确诊22例，胸部CT确诊18例。与是否进行急诊手术有关的因素有临床症状、合并疾病情况、术前误诊误治（经Fisher确切概率法统计，P值分别为0．010、0．010、0．011，均P＜0．05）。结论迟发型膈疝患儿的临床表现多样，临床上应积极完善相关检查，全面分析病情，早期诊断。
목적：총결지발형격산환인적림상표현，토론영향수술기한선택적인소。방법수집2006년1월지2013년6월，서안시인동의원수치지발형격산환인47례，대기년령、증상、체정、보조검사、합병질병、술중소견폐발육정황、수술기한등자료진행회고성분석。결과이호흡계통증상위주요표현취진자25례，점53％。이소화계통증상취진자14례，점30％。평소무증상，체검발현자8례。흉편학진22례，흉부CT학진18례。여시부진행급진수술유관적인소유림상증상、합병질병정황、술전오진오치（경Fisher학절개솔법통계，P치분별위0．010、0．010、0．011，균P＜0．05）。결론지발형격산환인적림상표현다양，림상상응적겁완선상관검사，전면분석병정，조기진단。
Objective To summarize the clinical manifestations of delayed diaphragmatic hernia in children and to analyze the influencing factors of operation time limit.Methods A retrospective analysis was conducted on the age , symptoms, signs, auxiliary examinations, comorbidities , intraoperative findings of lung development and operation time limit of 47 children with delayed diaphragmatic hernia treated in the period of January 2006 to June 2013 in Xi’an Children’s Hospital.Results There were 25 cases with respiratory symptoms as the main manifestation , accounting for 53%, and 14 patients with digestive symptoms as the main manifestation ( 30%) .Eight cases were diagnosed by physical examination but they were asymptomatic when not taking examination .There were 22 cases diagnosed with chest X-ray and 18 cases with chest CT .Clinical symptoms , combined diseases and misdiagnosis before operation were related factors of whether emergency operation was needed (The Fisher exact statistical conclusion:P value was 0.010,0.010 and 0.011, respectively, all P<0.05).Conclusion The clinical manifestations of delayed diaphragmatic hernia are various .Related examinations should be taken positively and the patients ’ condition should be analyzed from all aspects for early diagnosis .