创伤性膈疝的紧急处理及影响死亡因素分析

Diagnosis and treatment of traumaric diaphragmaticher

目的总结创伤性膈疝的死亡原因,诊断与治疗经验、教训,以提高早期诊断率,提高抢救成功率。方法对33例创伤性膈疝的临床资料进行回顾性分析与总结。结果全组术前确诊17例,误诊16例。治愈27例,死亡6例。结论创伤性膈疝是一种少见且极易被延误诊断的急性外伤性疾病,延误诊断率较高,因其缺乏特有的症状和体征,医生对此病警惕性不够,常常不能及时诊断。此病一经确诊均需手术治疗。

Objective Summarize the cause of death（COD）,the diagnosis and treatment strategies in the patients who has traumatic diaphragmatic hernia in order to improve the early diagnosis and successfully surgical intervention and outcome.Method We retrospectively analyze clinical materials of 33 cases of traumatic diaphragmatic hernias and make a summary.Result There are 17 cases which had been confirmed as traumatic diaphragmatic hernias before the surgeries,while 16 cases which had been misdiagnosed as others before the surgeries.27 cases had been cured while 6 cases died.Conclusion Because the traumatic diaphragmatic hernia is rare and has no characteristic symptoms and signs,the rate of misdiagnosis or delayed diagnosis is high in the acute traumatic patients.If the medical doctors are unaware of the possibility of such severe situation,the diagnosis usually is incorrect and delayed.If the traumatic diaphragmatic hernia is confirmed,the surgical intervention is inevitable.