创伤性膈疝的诊治（附23例分析）

目的 探讨创伤性膈疝的早期诊断和治疗。方法 对23例创伤性膈疝的资料进行回顾性分析。结果 术前确诊12例（52．2％），漏诊10例（43．5％），术中漏诊1例（4．3％）。全组治愈20例（87．0％），死亡3例（13．0％）。术中漏诊1例，因肠绞窄脓毒性休克死亡。结论 提高认识、动态观察病情和X线胸片、及时全面的手术探查可降低误诊率。通过早期诊断和及时治疗，大多数创伤性膈疝可以治愈，死亡同膈疝本身无关，延误诊治是引起死亡的主要原因。

Diagnosis and treatment of traumatic diaphragmatic hernia ( a report of 23 cases)

Objective To study the early diagnosis and treatment of traumatic diaphragmatic hernia(TDH). Methods Retrospective analysis of the clinical data of 23 cases of TDH was made. Result 12 cases(51%) were preoperatively diagnosed,10 cases(43.5%) misdiagnosed,1 case was misdiagnosed during exploration laporatomy. 20 cases(86.9%) were cured and 3(13.1%) died. 1 case died of toxic shock because of misdignosis resulted in intestinal strangulation. Conclusions Increasing knowledge, dynamic observation of the disease and X-ray, promptly exploration can reduce the rate of misdiagnosis of TDH. With early diagnosis and treatment, most cases of TDH can be cured. The main cause of the death results from delayed diagnosis and treatment, and not related to TDH itself.