创伤性膈疝26例诊治分析

Diagnostic and therapeutic analysis of 26 cases of traumatic diaphragmatic hernia

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。

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.