吴勇

[摘要] 目的 对影响先天性膈疝患儿生活质量的相关因素进行分析。 方法 选取2010年1月至2017年1月期间于我院就诊的先天性膈疝患儿（CDH）43例，年龄1.5～4.0岁，平均（2.0±0.5）岁;选取同时期于我院体检的年龄相近的正常儿童43例作为对照组，采用一般状况问卷、儿童生活质量普通适用核心量表4.0及健康卫生服务满意度量表评价患儿的生活质量，并对影响患儿生活质量的因素进行分析。 结果 两组儿童的一般资料差异无统计学意义（P>0.05）。CDH患儿的儿童生活质量普通适用核心量表4.0及健康卫生服务满意度量表评分分别为（47.21±2.85）分和（43.12±3.67）分，与健康儿童（77.52±3.15）分和（76.25±2.98）分相比明显降低，差异有统计学意义（P<0.05）;单因素分析结果显示，不同家庭收入CDH患兒的生活质量比较，差异有统计学意义（P<0.05）;多因素分析结果显示，影响CDH患儿生活质量的高危因素是家庭收入。 结论 CDH患儿的整体生活质量水平较低，家庭收入与此现象密切相关，进而为有针对性地对CDH患儿进行康复治疗及提高其生活质量提供了参考。

[关键词] 先天性膈疝;儿童;生活质量;相关因素

[中图分类号] R714.5          [文献标识码] B          [文章编号] 1673-9701（2021）12-0072-04

Analysis of factors affecting the quality of life of children with congenital diaphragmatic hernia

WU Yong

Department of Pediatrics， the People′s Hospital of Kaizhou District in Chongqing， Chongqing   405400， China

[Abstract] Objective To analyze the relevant factors affecting the quality of life of children with congenital diaphragmatic hernia. Methods A total of 43 children with congenital diaphragmatic hernia（CDH） treated in our hospital from January 2010 to January 2017 were selected， aged 1.5-4.0 years old， with an average age of（2.0±0.5） years old. Forty-three normal children of similar age who received a physical examination in our hospital during the same period were selected as the control group. The general condition questionnaire， the general applicable core scale 4.0 for children′s quality of life， and the health service satisfaction scale were used to evaluate the quality of life of the children. The factors affecting the quality of life of children were analyzed. Results There was no statistical difference in general data between the two groups（P>0.05）. The general applicable core scale 4.0 for children′s quality of life（47.21±2.85） points and the health service satisfaction scale （43.12±3.67） points of the children with CDH was significantly lower than those （[77.52±3.15]points and [76.25±2.98]points） of healthy children， and the difference was significant（P<0.05）. The results of the univariate analysis showed that CDH children with different family incomes had different quality of life， and the difference was statistically significant（P<0.05）. The results of multivariate analysis showed that the high-risk factor for the quality of life of CDH children was family income. Conclusion The overall quality of life of children with CDH is low. Family income is closely related to this phenomenon， which provides a reference for targeted rehabilitation of children with CDH and improving their quality of life.

[Key words] Congenital diaphragmatic hernia; Children; Quality of life; Related factors

先天性膈疝（Congenital diaphragmatic hernia，CDH）是一种罕见的由单侧或双侧膈肌发育缺陷导致腹腔脏器疝入胸腔的先天畸变现象[1，2]。CDH患者的发病率和死亡率均很高，其儿童发病率约为1/2200，围产期死亡率高达50%，严重威胁患者的生活和生存质量[3，4]。CDH多发于发育期间患儿膈肌未闭合时，腹腔内容物通过未闭合膈肌转入胸腔，改变胸腔负压状态，压迫肺组织造成肺部发育不良，严重者导致患儿出现急性呼吸困难、缺血缺氧等症状甚至造成患儿死亡[5，6]。此外，CDH患儿常伴有肺动脉高压、哮喘、胃食管反流病、食欲障碍以及发育迟缓等并发症[7，8]。近年来，越来越多的CDH患儿选择婴儿期，甚至新生儿期进行手术治疗，除传统的死亡率等医学指标外，患儿健康相关的生活质量（HRQoL）评估已成为全面评价儿童健康的重要指标。本研……