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目的 :总结分析28例创伤性膈疝的诊治经验。方法:回顾性分析2012年1月至2015年6月本院收治的28例创伤性膈疝患者的临床资料,其中男22例,女6例,急性27例,迟发型1例。28例全部手术,其中开胸切口26例,胸腹两切口1例,胸腔镜手术1例;膈肌直接缝合23例,补片修补5例。结果:术前确诊21例(1例胸片确诊,其余均CT确诊),术中确诊7例。误诊6例。手术时间50~180 min。治愈27例,死亡1例。结论:创伤性膈疝治疗的关键是早期诊断,CT三维重建是有效检查手段,手术是唯一治愈方法,术中根据缺损情况选择直接修补或补片修补。
Objective: To summarize and analyze the diagnosis and treatment of 28 cases of traumatic diaphragmatic hernia. Methods: The clinical data of 28 patients with traumatic diaphragmatic hernia admitted to our hospital from January 2012 to June 2015 were retrospectively analyzed. There were 22 males and 6 females, 27 were acute and 1 was delayed. Thirty-eight cases underwent surgery, including 26 cases of thoracotomy, 1 case of chest and abdomen incision, 1 case of thoracoscopic surgery, 23 cases of diaphragmatic muscle suture directly and 5 cases of patch repair. Results: Preoperative diagnosis of 21 cases (1 case of chest X-ray confirmed, the rest were CT confirmed), 7 cases were diagnosed. Misdiagnosed 6 cases. Surgery time 50 ~ 180 min. Twenty-seven cases were cured and one died. Conclusion: The key to the treatment of traumatic diaphragmatic hernia is early diagnosis. CT three-dimensional reconstruction is an effective means of examination. Surgery is the only cure method. According to the defect, direct or patch repair can be selected during operation.