目的 :分析目前临床常用的诊断方法与创伤性膈肌破裂漏诊的关系 ,判断这些诊断方法的价值。方法 :回顾性调查了 10例漏诊的创伤性膈肌破裂患者 (钝击伤 3例、穿通伤 7例 )在创伤初的病史、体征和物理学检查。结果 :初诊时仅 2 ,3例患者有轻度呼吸困难或腹肌紧张 ;仅 1例钝伤、3例穿通伤患者的胸片提示存在血气胸和 (或 )膈肌抬高 ;B超未能提示膈肌破裂 ;2例钝伤、2例穿通伤患者诊断性腹腔穿刺有阳性发现 ;1例钝伤、2例穿通伤患者做了胸腔闭式引流并有血、气排出 ;5例做了剖腹探查术仍未发现膈肌破裂。结论 :目前临床常用的诊断方法对发病早期、尚未发展成膈疝的创伤性膈肌破裂并不实用 Objective: To analyze the current clinical diagnostic methods and traumatic diaphragmatic rupture of missed diagnosis, to determine the value of these diagnostic methods. Methods: The history, signs and physical examination of 10 cases of traumatic diaphragmatic rupture (3 cases of blunt injury and 7 cases of penetrating injury) were retrospectively studied. Results: Only 2 or 3 patients had mild respiratory distress or abdominal muscle tension at initial diagnosis. Only 1 case of blunt trauma and 3 cases of thoracic penetrating traumatic brain injury indicated hematopneumothorax and / or diaphragmatic elevation. B-ultrasound failed Suggestive of diaphragmatic rupture; 2 cases of blunt trauma, 2 cases of penetrating traumatic patients diagnosed positive abdominal paracentesis; 1 case of blunt trauma, 2 cases of traumatic penetrating trauma done thoracic drainage and blood, gas excretion; 5 cases done cesarean section Exploring the diaphragm has not found rupture. Conclusion: At present, the diagnostic methods commonly used in clinical practice are not practical for the early onset of traumatic diaphragmatic rupture which has not developed into diaphragmatic hernia