损伤性膈肌破裂30例的临床分析

The clinical analysis of injury of the diaphragm a report of 30 cases

目的 总结 30例损伤性膈肌破裂的诊治经验。方法 对本科 1980年 6月～ 2 0 0 0年 5月收治的损伤性膈肌破裂 30例作一回顾性分析。结果 30例中开放性损伤 14例 ,闭合性损伤 16例 ,合并膈疝 2 0例 ,合并胸腹腔及全身多器官损伤 2 8例 ( 93.3% ) ,死亡 6例 ,病死率为 2 0 %。结论 损伤性膈肌破裂是临床上少见而危险性较大的损伤 ,术前确诊率低 ,病死率高。一经怀疑应及时手术 ,手术以开腹为首选。

Objective To review the experience in diagnosis and treatment of 30 cases of injury of the diaphragm.Methods 30 cases of injury of the diaphragm who were treated in our department from June 1980 to May 2000 were analyzed retrospectively.Results Of the 30 cases,14 resulted from open injuries and 16 due to closed injuries,including diaphragmatic hernia in 20 cases.93.3% of the patients had other associated injuries.The diagnosis was established preoperatively in 8 cases(26.7%).The overall mortality rate was 20%(6/30).Conclusion Injury of diaphragm was lesser in the clinic and more dangerous to health.The diagnosis was difficult preoperatively and the mortality rate was high.An operation must be performed once doubt,laparotomy was chosen first.