胸腔闭式引流不当致膈肌破裂1例  

Diaphragmatic rupture caused by inappropriate closed drainage of thoracic cavity:a case report

作　　者：汪洋[1] 张进祥[1] 杨冲[1] 陈立波[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院急诊外科,武汉430022

出　　处：《临床急诊杂志》2013年第3期135-136,共2页Journal of Clinical Emergency

摘　　要：胸腔闭式引流术是急诊创伤外科常用的治疗方法之一，其主要目的在于尽快排出患者胸腔积液，恢复胸腔负压，保持呼吸和循环的稳定。由于操作简便、术后便于监测的临床特点，该术式已广泛应用于外伤性胸腔积液（积血）患者的救治。但是，由于外伤患者独特的临床特点，加之术者操作不规范也会发生各种并发症，导致严重后果。我院于2012年6月收治因胸腔闭式引流不当致膈肌破裂患者1例，现报告如下。Drainage of thoracic cavity is a routine treatment for traumatic pleural effusion or pneumothorax, whereas improper operation may cause serious consequences. A case of 47-year-old man with traffic injury is repor- ted herein. The patient had abdominal pain, chest distress, and trouble breathing when admitted to our hospital. Af- ter admission, the patienfs blood pressure decreased, heart rate increased and blood was draw upon from the chest tubes. Chest examination indicated wet rales in both sides and decreased breath sounds in the left side. Abdominal examination reversed peritonitis symptoms. Abdominal X-ray indicated there were free gas under left hemidia- phragm and moderate amount of left pleural effusion. The abdominal computed tomography （CT） scan showed pleural drainage tube in the abdominal cavity which was closely related to spleen. We made diagnosis as following：①multiple injuries caused by traffic injury; ②diaphragmatic injury;③splenic rupture.

关 键 词：胸腔闭式引流 膈肌破裂 手术 

分 类 号：R64[医药卫生—外科学]