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[膈肌的创伤性损伤与疾病]

[Traumatic injuries and diseases of the diaphragm].

作者信息

Gredzhev A F, Kolkin Ia G, Kravets V M, Paniotov A P, Konoplia P P, Giul'mamedov S I, Kolesnik V V

出版信息

Khirurgiia (Mosk). 1991 May(5):93-7.

PMID:2072658
Abstract

The article analyses experience in diagnosing the pathological condition and treating 125 patients with acute injury to the diaphragm (61 patients) and chronic traumatic diaphragmatic hernias (64 patients). The authors indicate the therapeutic and diagnostic means in this pathological emergency due to the acute trauma of the chest and abdomen or incarceration of the abdomen. The diagnostic errors and their consequences are analysed. Operation was conducted on 104 patients. In ruptures of the diaphragm in the zone of the esophageal hiatus the cardia was drawn downwards and fastened under the diaphragm; in cases of fractures of the bony framework of the chest with the formation of fragments, panel fixation of the costal fragments and the sternum was carried out by the authors' methods. The results of the surgical interventions are shown (18 patients--17.4% died) with emphasis on the character of the disorders and the lapse of time from the development of the emergency to the application of therapeutic aid.

摘要

本文分析了125例急性膈肌损伤(61例)和慢性创伤性膈疝(64例)患者的病理状况诊断及治疗经验。作者指出了因胸腹部急性创伤或腹部嵌顿导致的这种病理急症的治疗和诊断方法。分析了诊断错误及其后果。对104例患者进行了手术。在食管裂孔区膈肌破裂时,将贲门向下牵拉并固定于膈肌下方;对于伴有骨折碎片形成的胸部骨骼框架骨折病例,作者采用其方法对肋骨碎片和胸骨进行钢板固定。展示了手术干预的结果(18例患者死亡,占17.4%),重点强调了疾病的特征以及从急症发生到实施治疗援助的时间间隔。

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