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目的探讨腹腔镜手术治疗陈旧性创伤性膈疝的安全性和有效性。方法回顾分析2011年3月~2014年2月我院收治陈旧性创伤性膈疝5例资料,男3例,女2例,年龄20~47岁,中位年龄36岁。车祸伤4例,高空坠落伤1例。术前均经CT确诊。采用腹腔镜手术,还纳疝入的腹腔器官,采用不可吸收线间断缝合修补膈肌缺损,4例缺损无法缝合修补,采用补片修补。结果 5例手术均成功实施,手术时间74~210 min,平均135 min;手术出血量10~70 ml,平均24 ml;术后住院时间4~8 d,平均6 d。随访3~36个月,平均19.5月,未发现膈疝复发。结论腹腔镜治疗陈旧性创伤性膈疝具有创伤小、术后恢复快、术后并发症少等优点,是治疗创伤性膈疝的有效手术方式。
Objective To investigate the safety and effectiveness of laparoscopic surgery in the treatment of old traumatic diaphragmatic hernia. Methods The data of 5 cases of old traumatic diaphragmatic hernia admitted to our hospital from March 2011 to February 2014 were retrospectively analyzed. There were 3 males and 2 females, aged from 20 to 47 years and a median age of 36 years. Traffic accident in 4 cases, fall injury in 1 case. Preoperative diagnosis by CT. Using laparoscopic surgery, but also hernia hernia into the abdominal organs, non-absorbable suture intermittent repair of diaphragmatic defects, 4 cases of defects can not be sutured repair, patch repair. Results All the 5 cases were successfully performed. The operation time ranged from 74 to 210 minutes (mean 135 minutes). The operative bleeding volume was 10 to 70 ml (average 24 ml). The postoperative hospital stay was 4 to 8 days (mean, 6 days). Follow-up 3-36 months, an average of 19.5 months, no recurrence of diaphragmatic hernia was found. Conclusion Laparoscopic treatment of old traumatic diaphragmatic hernia has the advantages of less trauma, faster recovery and fewer postoperative complications. It is an effective surgical treatment of traumatic diaphragmatic hernia.