印度罗塔克医学科学研究生学院（PGIMS）关于儿童膈肌损伤的13年经验
Thirteen Years' Experience of Diaphragmatic Injury in Children from the Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, India.
作者信息
Rattan Kamal Nain, Narang Rajat, Rohilla Seema, Maggu Sarita, Dhaulakhandi Dhara B
机构信息
Department of Pediatric Surgery, Post Graduate Institute of Medical Sciences, Pt BD Sharma University of Health Sciences, Rohtak 124 001, Haryana, India.
出版信息
Malays J Med Sci. 2011 Jan;18(1):45-51.
BACKGROUND
Diaphragmatic hernia is migration of abdominal viscera into the thoracic cavity through a defect in the diaphragm. In children, it is mostly congenital; traumatic diaphragmatic hernia being less common. This study aimed to review our experience with traumatic diaphragmatic rupture (TDR) and to identify the clinical findings and diagnostic modality that may help in early diagnosis and prompt therapy.
METHODS
The study involved 11 children (1-18 years old) with TDR who were hospitalised between 1993 and 2005. In addition to clinical examination, a plain X-ray of the chest and abdomen, an ultrasound, barium studies, and a computerised tomography (CT) scan were used to evaluate the patients.
RESULTS
All of the diaphragmatic ruptures occurred on the left side, with 10 occurring in the posterolateral part and 1 near the oesophageal hiatus. Two of our patients presented 7 and 10 days after the injury, and 1 patient presented 1 year after the trauma.
CONCLUSION
TDR should remain a diagnostic possibility in children. These patients are best assessed using a CT scan. New research on stem cells and tissue-engineered bioprosthetics may pave the path for better future therapies in these cases.
背景
膈疝是腹腔脏器通过膈肌缺损移入胸腔。在儿童中，大多为先天性；创伤性膈疝则较少见。本研究旨在回顾我们对创伤性膈肌破裂（TDR）的诊治经验，并确定有助于早期诊断和及时治疗的临床发现及诊断方式。
方法
本研究纳入了1993年至2005年间住院的11例1至18岁TDR患儿。除临床检查外，还采用胸部和腹部X线平片、超声、钡剂造影及计算机断层扫描（CT）对患者进行评估。
结果
所有膈肌破裂均发生在左侧，其中10例位于后外侧部分，1例靠近食管裂孔。我们的2例患者在受伤后7天和10天就诊，1例患者在创伤后1年就诊。
结论
TDR在儿童中仍应作为一种诊断可能。这些患者最好通过CT扫描进行评估。干细胞和组织工程生物假体的新研究可能为这些病例未来更好的治疗铺平道路。
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