胸部振水音诊断左侧膈疝的临床价值

Clinical Value of Chest Succussion Splash in Diagnosis of Left-diaphragmatic Hernia

目的探讨振水音诊断左侧膈疝的临床价值。方法观察左侧膈疝和其他疾病患者出现胸部振水音的情况,统计胸部振水音的阳性率和假阳性率。结果26例左侧创伤性膈疝患者中20例术前检查左胸部可闻及振水音,20例食管裂孔疝患者中10例行造影前检查左胸部可闻及振水音,振水音诊断左侧膈疝的阳性率为65.21%。同期另有27例高位肠梗阻和23例胃潴留患者中分别有8例和12例患者也出现了胸部振水音,假阳性率为40%。结论左侧胸部振水音对于左侧膈疝尤其是创伤性膈疝有一定的诊断价值。

Objective To investigate clinical value of succussion splash in diagnosis of left - diaphragmatic hernia. Methods Chest succussion splash presenting in left - diaphragmatic hernia patients and other patients was observed to determine positive and false positive rates of chest succession splash. Results In 20 of 26 patients with left traumatic diaphragmatic hernia, succssion splash was heard in left chest before surgery; in 10 of 20 patients with hiatal hernia, it was also heard in left chest before opacification. The positive rate of left - diaphragmatic hernia was 78.26% by succession splash. In 8 of another 27 patients with high bowel obstruction and in 12 of 23 patients with gastric retention, chest succussion splash appeared, with a false positive rate of 40%. Conclusion Left chest succussion splash is of important value in diagnosis of left diaphragmatic hernia, especially of traumatic diaphragmatic hernia.