创伤性膈疝的X线与CT诊断分析

Diagnostic value of X-ray and CT for traumatic diaphragmatic hernia

目的分析X线与CT在创伤性膈疝中的诊断价值及影像特点。方法对经X线、CT检查的35例创伤性膈疝患者(经手术证实)进行回顾性分析。结果①创伤性膈疝多发生于左侧膈肌,该组病例中X线与CT对该病的诊断符合率分别为68.6%和100%。②CT不仅可以明确诊断膈疝,还可判断膈破裂口的位置、大小、疝入物内容。③判断多脏器复合受损情况:CT在诊断肺挫裂伤方面与X线无显著性差异(P>0.05);CT在诊断液气胸、腹腔积液方面明显优于X线(分别为P<0.01,P<0.05);X线在诊断肋骨骨折方面明显优于CT(P<0.01);X线对肝、脾、脑、肾等实质性脏器的损伤方面无诊断价值。结论X线、CT在诊断创伤性膈疝中有着极其重要的作用,且CT是一种更敏感的检查方法,对创伤性膈疝的早期诊断及治疗、挽救患者生命有重大的意义。

Objective To evaluate the diagnostic value and imaging character of X-ray and CT for traumatic diaphragmatic hernia. Methods Thirty-five cases of traumatic diaphragmatic hernia（confirmed by operation）were retrospectively analyzed. Results ①Most of the diaphragmatic hernias were found in left thoraxes, and the diagnostic accuracy rate of X-ray film and CT scanning reached 68. 696 and 10096, respectively. ② CT could also judge the location and size of the fissures and the contents . ③ There was no significantly difference between CT and X-ray in diagnosing lung deflation （P〉0.05） ; CT was better than X-ray for diagnosing hydropneumothorax and ascites（P 〈 0.01, P 〈 0. 05） ;X-ray was better than CT in diagnosis of rib fracture （P 〈 0.01 ）;and X ray had no diagnostic value in the deflation of substance organs such as liver, spleen, brain, renal and so on. Conclsion Both X-ray and CT can diagnose early, and treat the traumatic diaphragmatic hernia. And CT is more sensitive.