创伤性膈疝的诊治体会

Diagonsis and treatment of traumatic diaphragmatic hernia

目的总结创伤性膈疝的诊治经验。方法回顾分析34例创伤性膈疝病例,其中穿透伤7例,闭合伤27例。19例行X线检查,11例有阳性发现。9例进行CT检查,8例有阳性发现。手术治疗采用剖胸术9例,剖腹术23例,胸腹联合切口手术2例。结果术前确诊20例(58.8%),手术探查确诊14例。治愈32例(94.1%),死亡2例(5.9%)。结论 CT和X线检查是诊断创伤性膈疝的主要诊断依据。早期诊断、及时手术是提高治愈率、降低病死率的关键。

Objective To summarize experiences in the diagnosis and trentment of traumatic diaphragmatic hernia. Methods The clinical data of 34 patients which were diagnosed as traumatic diaphragmatic hernia were analyzed retrospectively. Among the 34 cases, 7 patients were diagnosed as penetrating injuries and 27 patients were closed injuries. Of the 19 cases, 11 patients were diagnosed accurately by radiography. Of the 9 cases, 8 patients were diagnosed accurately by CT. Surgical treatrent of 9 cases with thoracotomy,23 patients with laparotomy. Results 32 patients were cured （94. 1% ） and 2 patients died （5.9%）. Conclusion Diagnosis can be made based on CT and radiography. Early diagonsis and early treatment are the key to improve the cure rate and reduce mortality.