12例儿童创伤性膈疝的诊断与外科治疗

Diagnosis and Treatment of Traumatic Diaphragmatic Hernia in Children (A Report of 12 Cases)

目的探讨儿童创伤性膈疝的临床特点、诊断与治疗方法。方法回顾性分析儿童创伤性膈疝12例,其中闭合性损伤10例,穿透性损伤2例。急性期膈疝10例,慢性期膈疝2例。结果本组手术治愈11例,1例死于合并的颅脑损伤(未做膈疝手术),术前误诊2例(16.7%)。结论儿童创伤性膈疝易被误诊,提高诊断意识并根据临床特征结合应用X线等影像检查方法,可提高早期确诊率;一旦确诊应早期手术治疗。

Objective To investigate the clinical manifestation, diagnostic and therapeutic approaches for traumatic diaphragmatic hernia in children. Methods 12 cases of traumatic diaphragmatic hernia in children were retrospectively reviewed, including closed trauma in l0 cases and penetrating trauma in 2 cases. Clinical appearance manifested as acute in l0 cases, chronic in 2 cases. Results 11 cases were cured and 1 died of concomitant craniocerebral injury. Preoperative misdiagnosis occurred in 2 cases. Conclusion Trau- matic diaphragmatic hernia in children is easy to be misdiagnosed, clinical manifestation in combination with image findings will be helpful, and surgical treatment is required in early stages.