先天性膈疝和创伤性膈疝的临床诊治研究

Study of clinical diagnosis and treatment of congenital diaphragmatic hernia and traumatic diaphragmatic hernia

目的通过临床病例分析总结先天性膈疝和创伤性膈疝的诊治区别。方法回顾性分析我院2001年1月～2011年5月收治的78例膈疝患者的临床诊治,其中先天性膈疝42例,创伤性膈疝36例,均行膈疝修补术。经腹手术修补35例,经胸手术修补40例,经胸腹联合手术修补3例。结果先天性膈疝42例中39例治愈,治愈率为93%,死亡1例,2例复发;创伤性膈疝36例中35例治愈,治愈率达97℅,死亡1例。结论膈疝是一种临床急症,病因不同,诊治应有所区别,关键是抓住重点,抓住时机为患者手术,解决患者的病痛,抢救患者的生命。

Objective To summarize the differences of diagnosis and treatment between congenital diaphragmatic hernia and traumatic diaphragmatic hernia through clinical case analysis. Methods The diagnosis and treatment of 78 patients with diaphragmatic hernia treated in our hospital from January 2001 to May 2011 were analyzed retrospectively, 42 patients had congenital diaphragmatic hernia and 36 had traumatic diaphragmatic hernia. All the patients received diaphragmatic hernia repair, 35 patients received transabdominal surgical repair, 40 cases were treated with transthoracic repair and 3 cases were treated with the combination of transthoracic and transabdominal surgical treatment. Results Among the 42 pa- tients with congenital diaphragmatic hernia, 39 were cured, 1 died and 2 had recurrence, the cure rate was 93%; among the 36 patients with traumatic diaphragmatic hernia, 35 patients were cured and 1 died, the cure rate was 97%. Conclu- sion Diaphragmatic hernia is one kind of clinical emergency, of which the diagnosis and treatment should be different ac- cording to different etiological factors. The key is to seize the opportunity to perform operation on patients, relieve their oain and rescue the lives of oatients.