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创伤性膈疝少见。我院1970至1996年收治腹部外伤和胸腹联合伤1321例,其中创伤性膈疝12例,发生率为0.91%。全组均行手术治疗,治愈11例,死亡1例,死亡率8.3%。认为应将患者所表现的胸腹部症状、体征与外伤史结合分析,配合影像学检查,急诊手术时常规仔细探查两侧隔肌的完整性,避免误诊。还应特别重视合并大血管损伤、胸内高压造成的急性呼吸、循环衰竭和疝入脏器绞窄的处理。
Traumatic diaphragmatic hernia rare. From 1970 to 1996, our hospital received 1321 cases of abdominal trauma and thoracoabdominal combined injury, of which 12 cases of traumatic diaphragmatic hernia, the incidence was 0.91%. All patients underwent surgical treatment, 11 cases were cured, 1 died, the mortality rate was 8.3%. That patients should be the performance of the chest and abdomen symptoms, signs and trauma combined with the history of analysis, with imaging studies, emergency surgery routinely carefully examine the integrity of both sides of the diaphragm, to avoid misdiagnosis. Special attention should also be given to the treatment of large blood vessel damage, intrathoracic pressure caused by acute respiratory failure, circulatory failure and hernia into the strangulation of organs.