2例妊娠合并膈疝报道

Pregnancy complicated with diaphragmatic hernia: 2 cases report

妊娠合并膈疝是非常罕见的急诊,多为零散的病例报告,主要症状为恶心、呕吐,腹痛、胸痛及胸闷、呼吸困难,由于妊娠与膈疝的临床症状相似,因此,此病缺乏特异的临床表现,患者出现恶心、呕吐及胸闷、气促等症状时,都以为是正常的妊娠反应,另外,妊娠期间,很多孕妇都不愿意行放射性检查,导致妊娠合并膈疝的临床漏诊、误诊率较高,从而使得诊治延误,同时妊娠合并膈疝导致心肺功能受损、肠道梗阻、绞窄或穿孔等严重并发症,孕产妇及胎儿死亡率很高,这强调了及时诊断和治疗的重要性。以下是2例妊娠合并膈疝病例的诊断及处理经验报道。

Pregnancy complicated with diaphragmatic hernia is a quite rare emergency,mostly sporadic case reports.The main symptoms are nausea,vomiting,abdominal pain,chest pain and chest tightness and dyspnea.Because the clinical symptoms of pregnancy and diaphragmatic hernia are similar,pregnancy complicated with diaphragmatic hernia lacks specific clinical manifestations.When the patient has symptoms such as nausea,vomiting,chest tightness,and shortness of breath,it is considered a normal pregnancy reaction.In addition,during pregnancy,many pregnant women are reluctant to undergo radiological examination,resulting in a high rate of clinical missed diagnosis and misdiagnosis of diaphragmatic hernia during pregnancy,thus delaying diagnosis and treatment.At the same time,pregnancy complicated with diaphragmatic hernia leads to serious complications,such as impaired cardiopulmonary function,intestinal obstruction,strangulation or perforation.Maternal and fetal mortality rates are high,highlighting the importance of prompt diagnosis and treatment.The following is a report on the diagnosis and treatment experience of two cases of pregnancy complicated with diaphragmatic hernia.