损伤性膈肌破裂诊断治疗的临床探讨(附38例报告)

【目的】总结38例损伤性膈肌破裂的诊治经验。【方法】对1993年8月—2004年5月本科收治的损伤性膈肌破裂38例作一回顾性分析。【结果】38例中开放性损伤16例,闭合性损伤22例,合并膈疝28例,经X线检查,26例有阳性发现;22例行CT检查,结果均为阳性;合并胸腹腔及全身多器官损伤35例(92.1%),术前确诊31例(81.6%),治愈32例,死亡6例,病死率为15.78%。【结论】损伤性膈肌破裂是临床上少见而危险性较大的损伤,术前确诊率较低,病死率高。CT和X线检查是诊断膈肌破裂和创伤性膈疝的主要依据。一经怀疑应及时手术治疗。

The clinical approach of diagnosis and treatment in traumatic rupture of diaphragm (report of 38 cases)

To review the experience in diagnosis and treaatment of 38 cases of injury of the diaphragm.38 cases of injury of the diaphragm who were treated in our department from August 1993 to May 2004 were analyzed retrospectively.of the 38 cases,16 resulted from open injuries and 22 due to closed injuries,including diaphragmatic hernia in 28 cases and the 26 of 38 cases be finally diagnosed with x-ray,the 22 cases with CT.92.1% ofthe patients had other associated injuries.The diagnosis was established preoperatively in 31 cases(81.6%).The overall mortality rate was 15.78%(6/38).Conclusion]Injury of diaphragm was lesser in the clinic and more dangerous to health.The diagnosis was difficult preoperatively and the mortality rate was high.examination of an x-ray and CT are mainstay of the rupture of diaphragm and diaphragmatic hernia.an operation must be performed once doubt.