摘要
目的 探讨创伤性膈肌破裂的诊断与治疗。方法 对我院 1976年 6月～ 2 0 0 3年 2月收治的创伤性膈肌破裂病人进行了回顾性分析。结果 本组病人的临床表现复杂 ,大多数缺乏特征性征象。 4 8例中术前明确诊断的仅 2 0例 ,确诊率 4 1.7%。全组死亡 2例 ,死亡率 4 .2 %。结论 创伤性膈肌破裂多数为左侧 ,主要损伤机制是刃器伤和钝性伤。根据症状、体征 ,结合胸部X线、上消化道造影、CT、人工气腹等检查 ,能提高诊断率 ;膈肌破裂一经确诊 ,应手术治疗 ;根据胸、腹脏器损伤的情况 。
Objective To explore the earlier diagnosis and treatment of traumatic diaphragmatic rupture.?Methods All of the traumatic diaphragmatic rupture patients in our hospital between June 1976 and February 2003 were reviewed retrospectively.?Results The preoperative diagnosis of diaphragmatic rupture was difficult because clinical signs and chest film finding lack specificity. Of 48 patients with diaphragmatic rupture,only 41.7% were diagnosed preoperatively. There were two deaths,both unrelated to the diaphragmatic trauma. The overall mortality was 4.2%. All surviving patients recovered without sequelae.?Conclusion Traumatic diaphragmatic rupture was produced by either blunt thoracoabodominal trauma or penetrating wounds of the diaphragm,most involving the left hemidiaphragm. In most patients,clinical signs,chest films,barium meal,CT scanning and artificial pneumoabdomen were helpful in establishing the diagnosis. Once the diagnosis is made,repair should be made as soon as possible. Operation can be accomplished by transthoracic route,abdominal incision,or a combined thoracoabdominal route.
出处
《创伤外科杂志》
2003年第5期328-330,共3页
Journal of Traumatic Surgery
