创伤性膈肌破裂的诊治

目的:提高创伤性膈肌破裂的诊治水平。方法:回顾分析1987年1月-2004年10月复旦犬学附属金山医院和解放军第149医院18例创伤性膈肌破裂患者临床资料,男15例,女3例。均为多发伤。左侧膈肌破裂16例,右侧1例,双侧1例手术经胸6例,经腹切口10例,胸腹联合切口2例。手术行疝回纳、修补膈肌裂口,并处理其它合并伤。结果:治愈15例,死亡3例。1例双侧膈肌破裂患者死于粉碎性肝破裂、创伤性休克、失血性休克:1例死于严重的脑外伤;1例死于呼吸、循环等多脏器功能不全。结论:提高认识,正确应用辅助检查,尤其是X线、CT等检查方法,有助于早期诊断。及时复苏、止确处理其他合并伤、及时手术,是提高治愈率的关键。

Diagnosis and Treatment of Traumatic Diaphragm Rupture

Objective: To improve diagnosis and treatment of traumaticdiaphragm rupture. Methods: 18 patients( 15 males and 8 females) with traumatie diaphragm rupture from January 1987 to October 2004 in JINSHAN HOSPITAI Fudan University and PLA 149 Hospital were retrospectively analyzed. They were all the multiple system organ injury. 16 patients were in left diaphragm. 1 case in right. 1 case in double. All patients were received operation after antishock and or other treatments. The intra abdomen( 10 cases ). intra thorax (6 cases) and intra thoracolapara incisions were selected. Results: 15 patients wen cured. patients died of severe craniocerebral injury.sever liver rupture with hemorrhagic shock, wound shock. MODS, respectively. Conclusion: Increasing knowledge for traumatic diaphragm rupture and using correctly the examination (X-ray,CT et al) might be helpful for diagnosis.The key 10 improve ability of treatment is to resuscitate and operate in time and to manage the complicating injuries.