创伤性膈疝21例诊治体会

目的　总结创伤性膈疝的临床特点 ,探讨诊断和治疗方法 ,以期提高诊治水平。方法　对 2 1例创伤性膈疝患者受伤的原因、临床表现、各项检查的诊断价值和手术治疗的术式及结果进行回顾性分析。结果　术前确诊 18例 ( 85 7% ) ,漏诊 3例 ( 14 3% ) ,术后痊愈 19例 ( 90 4 % ) ,死亡 2例 ,病死率 9 5 %。结论　创伤性膈疝以左侧多发 ,往往以胸痛、腹痛、气促、呼吸困难为主要症状 ,常合并有其他脏器损伤 ,容易漏诊。钡餐动态X线胸腹联透 ,最具诊断价值。手术径路主视胸腹合并伤情况选择。

Diagnosis and treatment of 21 cases of traumatic diaphragm hernia

Objective To summarize 21 cases of traumatic diaphragm hernia for improving the diagnosis and treatment method.Methods 21 cases data of traumatic diaphragm hernia including causes, manifestation, examination and surgical procedure were analyzed retrospectively. Results The diagnosis was confirmed in 18 cases(85.7%) preoperatively, missed in 3 cases (14.3%) . 19 cases were fully recovery postoperation (90.4%), 2 cases died(mortality 9.5%).Conclusion Traumatic diaphragm hernia has the clinical features of chest pain, abdominal pain, shortness of breath and dyspnea. It always combined with other visceral injury which could be misdiagnosed. The dynamic chest belly barium meal X-ray is the most efficient diagnosis method. Surgical approach depends on the status and situation of injury.