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胸部钝性损伤致膈肌疝和心包破裂:病例回顾

A Diaphragmatic Hernia and Pericardial Rupture Caused by Blunt Injury of the Chest: A Case Review.

作者信息

Gao Ru, Jia Donghui, Zhao Huimin, WeiWei Zhang, Yangming Wang Frank

机构信息

Department of Thoracic Surgery, No. 1 Hospital of BaoDing City, HeBei Province, PR China (Ms Gao and Drs Jia and Zhao); and College of Life Science, HeBei Agricultural University, HeBei Province, PR China (Mr WeiWei and Dr Yangming).

出版信息

J Trauma Nurs. 2018 Sep/Oct;25(5):323-326. doi: 10.1097/JTN.0000000000000395.

Abstract

Blunt traumatic diaphragmatic hernias are most commonly seen in combination with other injuries. Right diaphragmatic ruptures with serious pericardium ruptures are relatively rare. The diagnosis of diaphragmatic hernias is not difficult; however, prior to surgery, it is difficult to judge whether pericardium damage has occurred, particularly on the right side. This injury may occur in a critical pathological state in which cardiac tissue is outside the pericardium due to the pericardial defect. Severe hemodynamic disorders or even death may occur if the patient's condition is not diagnosed and treated in a timely manner. The transportation of patients with severe trauma must be performed with extreme caution. It is necessary to weigh a wide range of differential diagnoses in a serious and thorough initial investigation.

摘要

钝性创伤性膈疝最常见于合并其他损伤的情况。伴有严重心包破裂的右侧膈肌破裂相对少见。膈疝的诊断并不困难;然而,在手术前,很难判断是否发生了心包损伤,尤其是右侧。这种损伤可能发生在一种危急的病理状态下,即由于心包缺损,心脏组织位于心包外。如果患者的病情没有得到及时诊断和治疗,可能会发生严重的血流动力学紊乱甚至死亡。对严重创伤患者的转运必须极其谨慎。在认真、全面的初步检查中,有必要权衡各种鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/387f/6170143/4ff4a8da5e45/jtran-25-323-g001.jpg

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