摘要
目的总结创伤性膈疝早期诊断和外科治疗的体会。方法回顾性分析32例创伤性膈疝病人的临床资料,本组病人均施行膈疝修补术,其中经胸手术14例(胸腔镜下修补膈疝1例),经腹部手术18例。结果术中直接缝合破裂膈肌26例(81.3%),采用疝补片修补破裂膈肌6例(18.7%);全组治愈31例(96.8%),死亡1例(3.2%),死亡原因为呼吸衰竭。结论提高警惕性、动态X线和CT等影像学检查可及早发现膈疝,必要时可借助于胸腹腔镜探查;急性期可采用经腹入路,陈旧性膈疝采用经胸入路。
Objective To study the methods of diagnosis and treatment of traumatic diaphrag- matic hernia（TDR）. Methods A retrospective case note analysis was performed of 32 patients treated for TDR between July 2008 and December 2017, including the details of their clinical presentation, mode of diagnosis,operative findings and postoperative outcome. All patients underwent surgery for traumatic dia- phragmatic hernia, transabdominal was the most common surgical approach used in 18 cases ;Thoracotomy was needed in 14 cases（ one was by video assisted thoracoscopic repair）. Results 26 patients underwent repair of the diaphragmatic rupture using interrupted polypropylene suture, the remain patients underwent repair of the diaphragmatic rupture using additional Procedures. One patients died from their extensive in- juries shortly after. Conclusion An accurate diagnosis of diaphragmatic rupture in trauma patients is difficult, Careful attention, chest X-ray and CT thorax should be given for the diagnosis of diaphragmatic rup- tures. Surgical treatment will give good results.
作者
刘伟
黄杰
谢颂平
LIU Wei;HUANG jie;XIE Songping(Department of Thoracic Surgery,the Renmin Hospital of Wu-han University,Wuhan 430060,China)
出处
《临床外科杂志》
2018年第8期616-617,共2页
Journal of Clinical Surgery
关键词
创伤性膈疝
诊断
手术治疗
traumatic diaphragmatic hernia
diagnosis
surgery
