32例创伤性膈疝的诊断与治疗

Diagnosis and treatment of traumatic diaphragmatic hernia in 32 cases

目的:总结创伤性膈疝的诊治经验。方法:对32例创伤性膈疝的创伤原因,临床表现,辅助检查及治疗方法进行回顾性分析。结果:穿通伤7例,闭合伤25例,术前确诊28例,术中确诊4例。32例均行手术治疗,4例术后死亡,28例痊愈。结论:创伤性膈疝常合并多发伤,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,及时手术是成功救治此类患者的关键。

Objective To explore the diagnosis and treatment of traumatic diaphragmatic hernia.Method The traumatic causes,clinical manifestation,supplementary examination and curative methods were retrospectively analyzed in 32 cases with traumatic diaphragmatic hernia.Results Among the 32 patients,7 resulted from pentrating injuries and 25 of closed injuries.Twenty-eight cases of preoprative diagnosis,4 cases of intraoperative diagnosis,and 32 patients were treated by operation,their diaphragma were restored after their injuried thoracic and abdominal organ had been processed.Twenty-eight cases were cured,but 4 patients died after surgery.Conclusion Traumatic diaphragmatic hernia is often associated with multiple trauma.Diagnosis can be made according to the preoperative CT and X-ray examination.Early diagnosis and prompt surgery may be the key point to successful rescue of patients.