| 不同影像学方法诊断创伤性膈疝的体会 |
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| 作者姓名： | 高雷 廖杨 刘杰 熊颖 |
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| 作者单位： | 四川乐山市第三人民医院（五通桥区人民医院）放射科，四川 乐山 614800 |
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| 摘 要： | 目的通过不同影像学检查方法诊断两例创伤性膈疝的过程中，得到的经验教训，探讨并寻找价廉的、能方便快捷地、较为准确地诊断创伤性膈疝的方法，同时又要避免因患者不能配合所造成的干扰:如昏迷、烦躁、乱动等 方法收集两例创伤性膈疝患者影像学及临床、手术资料:一例因值班医师考虑不充分，仅作胸腹部CT平扫+膈肌薄层三维重建；一例经充分考虑后作胸腹部CT检查（平扫+膈肌薄层三维重建）+透视+摄片（留取影像记录）。比对两例病例作出的诊断结果，征询临床意见及手术结果。 结果临床反馈意见及手术结果均证实，透视下的诊断结果结合临床能较为快捷、准确地作出诊断，且有其独到的科学性。 结论充分认识膈疝的影像学表现、熟练掌握各种鉴别诊断、认真结合临床症状及体征，对于快捷准确地诊断创伤性膈疝并不难，从而更有效地减少死亡率、降低并发症以及提高治愈率。
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| 关 键 词： | 创伤性膈疝 计算机断层 透视 外伤史 反向运动 手术依据 |
| 收稿时间： | 2015-01-24 |
The experience of different imaging methods in the diagnosis of traumatic diaphragmatic hernia |
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| Authors: | Lei Gao Yang LIAO Jie LIU Ying XIONG |
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| Affiliation: | The third People's Hospital of Leshan in Sichuan(Wutongqiao District People's Hospital), Leshan 614800, China |
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| Abstract: | Objective Through the process of different imaging methods in the diagnosis of two cases of traumatic diaphragmatic hernia, get lessons learned, and to discuss and look for cheap, convenient and quick to, more accurately the method in the diagnosis of traumatic diaphragmatic hernia, at the same time avoid interference caused by patient can't cooperate, such as coma, be agitated, touch, etc. Methods Collect the images of two cases of traumatic diaphragmatic hernia and clinical data, operation: In one case, because the doctor on duty to consider is not sufficient，only the chest and abdomen CT scan + diaphragm thin layer 3 d reconstruction; Another case after taking full account of the chest and abdomen CT examination（CT scan + diaphragm thin layer 3 d reconstruction）+ X-ray fluoroscopy + X-ray radiography (leave medical image data). Then compare the diagnostic results of the two cases, the clinical observations and surgical results. Results Clinical feedback and surgical results were confirmed, the diagnosis results of X-ray fluoroscopy diagnosis combined with clinical can be more quick and accurate diagnosis, and has its unique scientific nature. Conclusion Fully aware of the imaging findings of diaphragmatic hernia, skillfully master all kinds of differential diagnosis, seriously in combination with clinical symptoms and signs, for fast and accurate diagnosis of traumatic diaphragmatic hernia is not difficult, so as to more effectively reduce mortality, reduce complications and improve cure rate. |
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