摘要
目的 探讨膈肌损伤的诊断与治疗。方法 5例膈肌损伤中穿透性损伤 2例 ,闭合性损伤 3例。 5例均合并其它脏器伤( 1 0 0 % )。经胸手术 2例 ;经腹手术 3例 ,其中 2例改为胸腹联合切口。术前确诊 1例 ( 2 0 % )。结果 全组均痊愈出院 ,无病死病例。结论 胸痛、胸闷、气急和腹痛是膈肌损伤的四大症状。CT检查肺挫伤、血胸或血气胸及同侧肝或脾周积液是膈肌损伤的间接征象。手术是诊断膈肌损伤的主要方法 ,术中仔细检查是减少漏诊的关键。胸腹部穿透伤以经胸手术 ,胸腹部闭合伤以经腹手术为宜。
AIM To study some characteristics in diagnosis and treatment of injury of the diaphragm. METHODS Summarized the diagnosis and treatment of 5 cases of injury of the diaphragm. Of the 5 cases, 2 resulted from penetrating injuries and 3 due to closed injuries. All patients had other associated injuries. 2 patients operated with thoracotomy and 3 with laparotomy, including 2 with subsequent abdominothoracic incisions. RESULTS The diagnosis was established preoperatively in one case(20%). No patient died. CONCLUSION Injury of the diaphragm has mainly four symptoms: chest pain, chest tightness, panting and abdominal pain. CT can reveal indirect characteristics of injury of the diaphragm, such as: lung contusion, hemothorax, hemopneumothorax and hydrops around liver or spleen. Operation is the main method for making a diagnosis of injury of the diapharagm.The key in reducing misdiagnosis is careful inspection of the diaphragm at operation. It is suitable for treating thoracoabdominal penetrating injury with thoracotomy and thoracoadbominal closed injury with laparotomy.
出处
《安徽医药》
CAS
2004年第3期208-209,共2页
Anhui Medical and Pharmaceutical Journal
关键词
膈肌损伤
诊断
治疗
肺挫伤
血胸
血气胸
injuries of the diaphragm
penetrating injury
closed injury
operation
