创伤性膈肌破裂的诊断与治疗

目的探讨创伤性膈肌破裂早期诊断和治疗的方法。方法回顾性分析19例创伤性膈肌破裂的临床资料。闭合性损伤14例，开放性损伤5例。5例由胸部X线片确诊，11例由胸部CT确诊，3例经手中探查确诊。结果16例患者于术前得到确诊；18例患者经积极手术治疗均治愈，1例患者因严重肝破裂失血性休克死亡。术后并发出现肺不张1例，膈下脓肿1例，经积极治疗后治愈。结论增强对创伤性膈肌破裂的认识，详细采集病史及查体，通过胸部X线片或CT及时诊断和手术修补破裂的膈肌是提高治愈率及减低并发症的关键。

The diagnosis and treatment of traumatic diaphragmatic rupture

Objective To explore the diagnosis and treatment of traumatic diaphragmatic rupture and diaphragmatic hernia. Methods The clinical data of 19 cases treated for traumatic diaphragmatic rupture and diaphragmatic hernia were retrospectively analyzed. Among these 19 cases, 5 resulted from penetrating injuries and 14 due to closed injuries. 5 of these 19 cases were accurately diagnosed by radiography and 11 cases were accurately diagnosed by CT scanning, 3 cases diagnosed by intraoperative exploration. Results The diagnosis was established preoperatively in 16 cases. 18 patients were cured and 1 patients died of severe liver rupture complicated with uncontrolled hemorrhagic shock. Postoperative com- plications occur 1 cases of atelectasis, 1 cases of subphrenic abscess. All were cured after treatment by the positive. Conclusion The diagnosis of traumatic diaphragmatic rupture can be made by radiography and CT scanning. Early diagnosis and timely operation are key points for raising cure rate and reducing mortality rate.