膈肌损伤的诊治体会——附28例报告  

The diagnosis and treatment of the diaphragm injury——report of 28 cases

作　　者：李星云[1] 朴志刚[1] 池永涌[1] 李成福[1] 王洋 崔苍海[1] 

机构地区：[1]延边大学医学院附属医院胸外科,吉林延吉133000

出　　处：《延边大学医学学报》1999年第2期132-134,共3页Journal of Medical Science Yanbian University

摘　　要：［ 背景］ 总结２８ 例膈肌损伤的诊断与治疗经验．［ 病例报告］２８ 例中穿透性损伤１６ 例，闭合性损伤１２ 例；２８ 例全部合并其他脏器伤；经胸手术１９ 例，经腹手术７ 例，胸腹联合切口２ 例，其中３ 例为剖腹手术后又开胸；术前确诊２２ 例（７９ ％ ） ；全组中死亡２ 例（７ ％ ） ．［ 讨论］ 病人主诉和体格检查所见常是合并伤的表现，而胸部Ｘ 线检查是最可靠的诊断方法．术前对膈肌损伤的高度警惕和术中仔细检查膈肌是减少漏诊的关键．剖胸手术对破损的膈肌修补及破损脏器的处理提供良好的手术视野。BACKGROUND To summarize the diagnosis and treatment of 28 cases of injury of the diaphragm.CASE REPORT Of the 28 cases 16 resulted from penetrating injuries and 12 were due to closed injuries.Thoracotomy in 19 cases and laparotomy in 7,including one case requiring subsequent thoracotomy. The diagnosis is established preoperatively in 22 cases(79%).The overall mortality rate was 2 cases(7%).DISCUSSION Patients chief complaints and physical examination findings are usually the key for reliable diagnosis.Being alert to the possibility of diaphragm injury before operation and careful inspection of the diaphragm at operation are the key in reducing misdiagnosis.Initial laparotomy is a better operative approach for exploring either right or left diaphragm injury or for surgical repair.

关 键 词：膈疝 膈肌损伤 诊断 治疗 

分 类 号：R655.6[医药卫生—外科学]