急性创伤性膈肌破裂的早期诊断和治疗

Early diagnosis and surgical treatment of acute traumatic diaphragmatic rupture

目的:总结急性创伤性膈肌破裂的早期诊治经验。方法:回顾性分析1996-08-2012-08我院收治的37例急性创伤性膈肌破裂患者临床资料,对其发病原因、合并伤、诊断及手术方式分别进行分析。结果:术前确诊21例,术中探查确诊16例,治愈33例,死亡4例。结论:早期诊断和积极手术治疗是救治创伤性膈肌破裂的关键。动态观察伤员病情变化,及时行胸部X片或CT检查是早期诊断膈肌破裂的主要措施,一旦确诊都应手术治疗。

Objective：To summarize the clinical experiences of early diagnosis and surgical treatment of acute traumatic diaphragmatic rupture in 37 patients. Method： The clinical materials of 37 cases with acute traumatic dia phragmatic rupture in our hospital from August 1992 to August 2012 were retrospectively reviewed. The etiology, complicaled injury,diagnosis and surgical approach were analyzed. Result： 21 patients were definitly diagnosed be fore the surgery,and i6 patients were diagnosed definitly during the surgery. 33 patients were cured and 4 patients died. The overall cure rate was 89.19~. Conclusion： The early diagnosis and active treatment of complicated inju- ries is the key to cure the traumatic diaphragmatic rupture. Keeping consistent observation,chest plain X--ray and CT in time were the main measures to diagnose. Once the diagnosis of diaphragmatic rupture was established,e- mergency operation should be performed immediately.