Kunz M, Brülhart K B, Kossmann T, Trentz O
Klinik für Unfallchirurgie, Departement Chirurgie, Universitätsspital Zürich.
Helv Chir Acta. 1994 Apr;60(4):517-23.
Between 1987 and 1992, 17 patients sustaining injury of the diaphragm were treated at our institution. All patients had associated injuries. Blunt diaphragmatic rupture (n = 13) was mostly diagnosed by chest X-ray, additional diagnostic procedures (contrast radiography, sonography) confirmed a suspected diaphragmatic rupture. In all 4 cases with penetrating injury the diagnosis was found by explorative laparotomy. In 2 patients sustaining blunt diaphragm rupture the diagnosis was delayed by 2 and 6 days. 3 patients (all sustaining blunt diaphragm rupture) died related to their associated injuries. All patients sustaining blunt or penetrating thoracoabdominal trauma, specially in high-velocity road accidents and injuries by shots or knives, are suspicious for diaphragmatic injury.
1987年至1992年间，我院共收治17例膈肌损伤患者。所有患者均合并其他损伤。钝性膈肌破裂（13例）大多通过胸部X线诊断，其他诊断方法（造影、超声）则用于确诊可疑的膈肌破裂。4例穿透伤患者均通过剖腹探查确诊。2例钝性膈肌破裂患者的诊断分别延迟了2天和6天。3例患者（均为钝性膈肌破裂）死于合并伤。所有钝性或穿透性胸腹外伤患者，尤其是在高速交通事故以及枪击或刀伤中，均应怀疑有膈肌损伤。
