创伤性膈肌破裂的诊治

Diagnosis and treatment of traumatic diaphragmatic rupture

目的探讨膈肌破裂的特点及诊断、治疗方法。方法总结我院收治的创伤性膈肌破裂患者16例的临床资料。手术治疗15例,非手术治疗1例。手术方法包括经胸膈肌破裂修补术8例,经腹膈肌破裂修补术5例,胸腹联合膈肌破裂修补术2例;脾切除2例,脾修补术1例,胃穿孔修补术2例,空肠破裂修补术4例,小肠切除吻合术2例,结肠破裂造瘘术1倒。结果死亡1例,其余所有病例均痊愈出院。结论创伤性膈肌破裂应争取尽早诊断,一经诊断应手术治疗,应根据患者的病情采取相应的手术切口和术式。

Objective To discuss the characters, diagnosis and treatment of traumatic diaphragmatic rupture （TDR）. Methods Summarizing 16 patients with TDR in our hospital. Fifteen patients were treated with operation, 1 patient with nonoperation. The operation included TDR repair via thoracotomy in 8 patients, laparotomy in 5 patient, and laparotomy with thoracotomy in 2 patients. Splenectomy in 2 patients, spleen repair in 1 patient, gastric perforation repair in 2 patients ,jejunum perforation repair in 4 patients, small intestine anastomose in 2 patients, colostomy in 1 patient. Results One patient died, others were all recovered. Conclusion TDR should be diagnosed as soon as possible. Operation should be carried out when patients are diagnosed and should be done according patients state of illness.