创伤性膈疝的早期诊断与急救

目的：总结创伤性膈疝早期诊断与治疗的经验,提高临床诊治水平。方法：回顾性分析1994～2007年我院收治的16例创伤性膈疝病例的临床资料。24h内确诊15例,术前确诊8例。经胸切口3例,经腹切口8例,经胸和经腹切口3例,胸腔镜膈肌修补1例。结果：15例痊愈,1例死亡。结论：创伤性膈疝早期易误诊,胸部X线、B超和胸部CT是确诊的依据,早期诊断和手术,正确处理合并伤,是提高创伤性膈疝治愈率的关键。

Early Diagnosis and Therapy of Traumatic Diaphragmatic Hernia

Objective: To sum up the experiences in early diagnosis and therapy of traumatic diaphragmatic hernia and to improve the level of clinical nutrition and treatment. Methods: The clinical data of 16 patients with traumatic diaphragmatic hernia from 1994 to 2007 were analyzed retrospectively. 15 cases were correctly diagnosed in 24 hrs after traumas. The diagnosis was established before operation in 8 cases. Thoractomy was used in 3 cases and laparotomy in 8 cases. 3 cases were required thoractomy and laparotomy in the same time. Anocelia lens was used to repair diaphragm in 1 case. Results: 15 cases were cured and 1 died. Conclusion: Misdiagnosis is quite frequently in the early phase of traumatic diaphragmatic hernia. Chest X-ray, B ultrasonic and chest CT play important roles in making a correct diagnosis. Early diagnosis,prompt operation and correct treatment of associated injury are all important factors to improve the cure rate.