创伤性膈肌破裂的临床诊治特点

Clinical characteristic of diagnosis and treatment of traumatic diaphragm rupture

目的探讨创伤性膈肌破裂的诊治特点。方法回顾性分析32例创伤性膈肌破裂的诊治特点。其中开放性损伤14例,多为刀刺伤;闭合性损伤18例,以交通伤多见。结果32例中,术前确诊膈肌破裂19例(59·4%),13例术中探查确诊。治愈28例,死亡4例。结论创伤性膈肌破裂受伤机制及伤情复杂严重,休克及死亡率高。明确诊断正确处理至关重要,原则上宜先处理胸部外伤,后处理腹部外伤。

Objective To investigate the characteristic of diagnosis and treatment of traumatic diaphragm rupture. Methods The characteristic of diagnosis and treatment of 32 cases with traumatic diaphragm rupture was analyzed retrospectively. 14 cases were injured by sharp instrument and the other cases with blunt injury mainly caused by traffic accidents. Results Of 32 cases, 19 had diaphragmatic ruptures preoperatively, 13 diaphragmatic rupture was found during the operation. 28 cases cured and 4 cases died. Conclusions The mechanism of traumatic diaphragm rupture and patients＇ symptoms and sign are severe and complicate with a high shock and mortality. Correct diagnosis and management of traumatic diaphragm rupture are very important. The treatment principle is thoracic injures first and laparotomy second.