论文部分内容阅读
膈肌破裂临床不常见,其表现差异较大,常合并其他组织器官损伤,若不能早期诊断与及时处理,病死率较高,我院1983-2003年共收治膈肌破裂7例,现报告如下。1临床资料本组年龄20～68岁,均为男性,腰背部砸伤3例,胸或腹部挤压伤4例,7例入院时均有气促,呼吸28-50次/min,Bp50.0～82.5/38.3-54.1mmHg(1mmHg=0.133kPa),合并脾破裂2例,脊椎骨折3例,多根肋骨骨折2例,骨盆骨折1例,7例均为左侧膈肌破裂,都有腹腔器疝入胸腔,3例分别位于后外侧,前外侧,2例位于隔顶,1例侧前方膈肌附郦部撕脱,长20cm。裂口为直线的4例,长7～15cm,1例为“V”形,长13cm。治疗情况本组手术治疗6例,入院24h内手术4例,48h内手术2例,1例伤后6d确诊,行保守治疗。结果:手术治疗6例全部治愈,保守治疗者一度病情稳定,入院16d后
Diaphragmatic rupture is not uncommon clinical manifestations vary greatly, often combined with other tissue and organ damage, if not early diagnosis and timely treatment, high mortality, our hospital from 1983 to 2003 were treated diaphragm rupture in 7 cases, are as follows. 1 Clinical data The group aged 20 to 68 years, were men, three cases of lower back injury, crush injury in the chest or abdomen in 4 cases, 7 cases were admitted to have shortness of breath, breathing 28-50 beats / min, Bp50. 0 ~ 82.5 / 38.3-54.1mmHg (1mmHg = 0.133kPa), splenic rupture in 2 cases, vertebral fracture in 3 cases, multiple rib fractures in 2 cases, pelvic fractures in 1 case, 7 cases were left diaphragm rupture, both have abdominal cavity The herniation into the thoracic cavity, 3 cases were located in the posterolateral, anterolateral, 2 cases in the septum, 1 case of anterior side of the diaphragm attached to the Department of avulsion, length 20cm. Rip straight line in 4 cases, length 7 ~ 15cm, 1 case of “V” shape, length 13cm. Treatment of this group of 6 cases of surgical treatment, admission within 24h surgery in 4 cases, 48h surgery in 2 cases, 1 case 6d diagnosis, conservative treatment. Results: All the 6 cases were cured by surgery, and conservative treatment was once stable. After 16 days of admission