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创伤性膈疝的诊断与治疗

Diagnosis and treatment of traumatic diaphragmatic hernia

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【作者】 黄文涛罗占元陈晓明马日新

【Author】 HUANG Wentao, LUO Zhanyuan, CHEN Xiaoming, et al. Department of Thoracic Surgery, People’s Hospital of Jiangmen, Jiangmen 529050, China

【机构】 江门市人民医院胸外科江门市人民医院胸外科 529020529020

【摘要】 目的 总结创伤性膈疝的诊断和治疗经验。 方法 分析 2 7例创伤性膈疝患者受伤的原因、入院时的主要症状、体征、合并伤、主要检查资料及手术时机、死亡原因。钝性伤 13例 ,锐器穿透伤 14例 ;左膈疝 2 5例 ,右膈疝 2例 ;经腹手术 14例 ,经胸手术 13例。 结果  2 2例(81.5 % )术后痊愈 ,5例死亡 ,死亡率 18.5 %。 结论 胸腹部创伤患者应警惕膈肌的损伤 ,创伤性膈疝的表现常被合并伤的表现所掩盖 ,要注意受伤的原因、体位及外力作用的方向。认真的胸部X线电视透视是最可靠的检查方法。创伤性膈疝一经发现 ,应尽快给予手术治疗

【Abstract】 Objective To report the clinical diagnosis and treatment of traumatic diaphragmatic hernia (TDH). Methods An analysis was done on injury causes, major symptoms, physical signs, associated injury, examination data, operation time and death causes of 27 cases of TDH. Of 27 cases, there were 25 cases of left-diaphragmatic hernia, 2 right diaphragmatic hernia, 13 closed injury and 14 penetrating injury. Thoracotomy was performed in 13 cases and laparotomy in 14. Results Twenty-two cases (81.5%) survived after operation but 5 died with a mortality rate of 18.5%. Conclusions We must be alert to the possible diaphragmatic injury in the patients with thoracic injuries. TDH is easily neglected because of complications in the chest and the abdomen. Attention should be paid to injury cause, posture and direction of the outside force. Chest X-ray is the most reliable method for a diagnosis. The corresponding operation should be done as soon as possible.

  • 【文献出处】 中华创伤杂志 ,Chinese Journal of Traumatology , 编辑部邮箱 ,2002年12期
  • 【分类号】R655.6
  • 【被引频次】37
  • 【下载频次】167
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