创伤性膈疝26例诊治分析

目的 总结创伤性膈疝的诊治经验。方法 回顾性分析26例创伤性膈疝临床资料,其中开放性损伤7例,闭合性损伤19例。92.3％(24/26)的病人合并其它脏器损伤。手术采用剖腹术16例,剖胸术6例,胸腹联合切口4例。结果 术前确诊19例(73.1％),治愈24例,死亡2例。结论 创伤性膈疝一经确诊应尽早手术治疗。胸部X线检查最具诊断价值。早期诊断、尽早手术修补膈肌裂口,及时、正确地处理合并脏器伤是提高治愈率的关键。

Diagnostic and therapeutic analysis of 26 cases of traumatic diaphragmatic hernia

Objective To summarize the esperience of diagnosis and treatment of traumatic diaphragmatic hernia. Methods 26 cases of traumatic diaphragmatic hernia were analyzed restrospectively. Among the 26 cases, 7 cases were open injuries and 19 cases were closed injuries. Combined injury of other organs accounted for 92. 3% (24/26). Laparotomy was porfomed in 16 cases, exploratory thoracotomy in 6 cases and abdomino-thoracic incision in 4. Results The diagnosis was established preoperatively in 19 cases (73. 1% ). 24 patients were cured and 2 died. Conclusion Once the diagnosis of traumatic diaphragmatic hernia is established, surgical operation should be performed as early as possible. Chest X-ray plays an important role in making a diagnosis. Early diagnosis, timely surgical repairs of diaphragmatic rupture, prompt and correct treatment of associated injuries are the key to improve the cure rate.