外伤性隔膜破裂的外科治疗

J.-P. Favre (Professeur des Universités, Chirurgien des Hôpitaux, Chef de Service), N. Cheynel (Maître de conférences des Universités, Chirurgien des Hôpitaux), L. Benoit (Chirurgien des Hôpitaux), P. Favoulet (Chef de clinique-assistant des Hôpitaux)
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引用次数: 25

摘要

隔膜破裂发生在严重的钝性创伤中;这是严重损伤的标志。侧面撞击时膈肌破裂的风险是正面撞击后的3倍。由于临床症状的特异性较差,膈肌破裂的诊断仍然存在问题。放射学显示腹部内脏的隆起,而不是横膈膜的不连续。因此,它的鉴定在急性期经常被遗漏,以后可能会被发现。一旦确诊,手术治疗包括通过腹部入路缝合,通常比只有很少适应症的胸部入路更可取。腹腔镜检查是一种新的方法,可用于血液动力学良好的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traitement chirurgical des ruptures traumatiques du diaphragme

Diaphragmatic rupture occurs in major blunt trauma; it is a marker of severe injury. The risk for diaphragmatic rupture is 3-fold higher in case of lateral impact than after frontal impact. The diagnosis of diaphragmatic rupture remains problematic due to the poor specificity of clinical signs. Radiology shows the elevation of abdominal viscera rather than the discontinuity of the diaphragm. So, its identification is frequently missed in the acute phase, and it may be discovered later. Once the diagnosis has been established, the surgical treatment consists of a suture by an abdominal approach, often preferred to the thoracic approach which has only few indications. Laparoscopy is a new approach that may be used in a patient with a good haemodynamic situation.

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