Clinical retrospective and comparative study on diaphragm injuries in 46 cases

Objective: To explore a way of guiding diagnosis and treatment of blunt and penetrating diaphragm injuries. Methods: According to injury violence, 46 chest trauma patients with diaphragm rupture were divided into two groups: a blunt injury group and a penetrating injury group. The injury condition and trauma scores between the two groups were compared and analyzed. Results: The incidence of blunt diaphragm injuries was lower than that of penetrating injuries ( 1.78 % vs 8.53 %, P< 0.05 ). In the blunt injury group most patients had multiple injuries. Penetrating injuries developed more quickly than blunt injuries, and resulted in hemorrhagic shock in the early period. Trauma scores showed that there was no significant difference in the Revised Trauma Score (RTS), the Injury Severity Score (ISS) and thoracic Abbreviated Injury Scale (AIS) between the two groups (P> 0.05 ), but the blunt injury group had lower Glasgow Coma Scale (GCS) and abdominal AIS than the penetrating group (P< 0.05 ). Conclusions: Blunt and penetrating diaphragm injuries have different clinical characteristics. So they should be dealt with differently to reduce the incidence of complication and improve prognosis.