About 21 cases of right traumatic diaphragmatic rupture of experience（对21例外伤性横膈破裂的经验）.docVIP

About 21 cases of right traumatic diaphragmatic rupture of experience Thesis network: traumatic diaphragmatic rupture (traumatic diaphragmatic rupture, TDR) is a rare abdominal surgical emergency, the incidence rate is approximately 5%. Diaphragmatic rupture itself, the lack of typical clinical signs of injuries early is not easy to make a diagnosis, and easy to delay in treatment fatality rate of up to about 34% [1]. Early diagnosis and timely treatment is very important since August 1999 to December 2010 were treated in the right side of 21 patients with TDR, are as follows. 1 clinical data 1.1 General situation: In 21 patients, 17 males and 4 females. Aged 17 to 76 years, mean 38 years. Sharps injuries in six cases of traffic accident injury, seven cases of fall injury in four cases of crush injury in four cases. The cases were multiple injuries, including 18 cases of pulmonary contusion, pneumothorax, liver rupture of six cases, renal laceration four cases, the digestive tract rupture in four cases, pelvic fracture and bladder rupture in three cases. 1.2 Diagnosis: admission, chest pain, 20 cases, abdominal pain, 18 cases, 16 cases of difficulty breathing, peritoneal irritation sign in 12 cases, 18 cases of fluid pneumothorax. Preoperative X-ray diagnosis of traumatic diaphragmatic hernia in eight cases, accounting for 38.1%, preoperative misdiagnosis In 13 cases, accounting for 61.9%, confirmed by intraoperative exploration. 1.3 treatment: 21 cases in transthoracic surgery in 10 cases, 8 cases of abdominal surgery through the abdominal incision .8 cases, three cases of diaphragmatic hernia formation, including two cases of strangulated diaphragmatic hernia hernia into the organ followed by colon, part of the liver, small intestine and greater omentum in the surgery by the removal of inactivation of the diaphragm, repair and / or the removal of ruptured organs, is also satisfied that the abdominal viscera herniated into the chest to r