创伤性膈肌破裂的早期诊断和外科治疗

目的 :　总结创伤性膈肌破裂 (TDR)的早期诊断和外科治疗的临床经验 ,探讨早期明确诊断对病情转归的影响。　方法 :回顾性分析 1983年 1月至 2 0 0 3年 1月该院收治的 2 8例TDR患者的临床资料 ,对其发病原因、部位、合并伤及损伤严重程度评分、诊断经过及手术途径等分别进行分析。　结果 :2 8例患者均经外科手术治疗后痊愈出院。与早期诊断组相比 ,延迟诊断组的术后并发症发生率较高 ,平均住院时间显著延长 (P <0 .0 1)。　结论 :早期诊断和积极治疗合并伤是救治TDR的关键。

Early diagnosis and surgical treatment of traumatic diaphragmatic rupture

Objective: To summarize the clinical experiences of early diagnosis and surgical treatment of traumatic diaphragmatic rupture. Methods: The clinical materials of 28 patients with traumatic diaphragmatic rupture from January 1983 to January 2003 were retrospectively reviewed, which etiology, traumatic position, complicated injury, score of injury degree, diagnosis course and surgical approach were analysed. Results: All patients were cured through surgical operation with uneventful postoperative course. The close thoraco-abdominal trauma(71.3%)was the main cause in our cases. The prognosis was effected by the early diagnosis markedly. The prevalence of postoperative complication in the delayed diagnosed cases was greater than in the early diagnosed cases and the length of hospital stay prolonged significantly. Conclusion:The early diagnosis and active treatment of complicated injuries is the key of the cure of traumatic diaphragmatic rupture.