急性创伤性膈疝的诊治探讨

Diagnosis and Treatment of Acute Traumatic Diaphragmatic Hernia

目的探讨急性创伤性膈疝诊断要点、治疗方法以提高治愈率,减少并发症。方法回顾性分析7例急性创伤性膈疝的诊断治疗过程,术前诊断6例,术中诊断1例;经腹手术6例,经胸腹联合切口1例。结果本组7例均治愈。其中术后出现肠梗阻1例,胸腔感染1例,切口感染1例。结论急性创伤性膈疝误诊率高,早期及时诊断是直接影响治愈率的关键。应重视临床表现,动态观察病情,伤后定期复查十分必要,可疑病例应积极探查。

Objective To explore the diagnostic essentials of acute traumatic diaphragmatic hernia(ATDH)to in- crease the cure rate and reduce the complication.Methods The process of diagnosis and treatment of 7 cases with ATDH were analyzed retrospectively.The diagnosis was confirmed pre-operatively in 6 cases and 1 case during operation.6 cases were treated with laparotomy and 1 with thoracolaparotomy.Results 7 cases were all cured.1 case had complication of ileus, 1 with thorax infection and 1 with incision infection after the operation.Conclusion Misdiagnosis rate is quite high in ATDH. Diagnosis in time in the early phase is the linchpin which influence the cure,rate directly.We should pay close attention to clinical manifestations and observe the patient's condition.It's very necessary to coantercheck after injury.An active operation should be done for suspicious cases.