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Results: different operations were performed as following:debridement suture of hepatorrhexis in 15 cases, debridement with greater omentum or gelatin sponge packing in 9 cases,resectional debridement in 7 cases,gauzes packing in 3 cases,suture of inferior vena cava in posterior segment of liver and hepatic vein stem in 2 cases.29 cases were cured(cure rate was 80.56%),7 cases died(mortality was 19.44%).the causes of death were multiple organ dysfunction syndrome in 3 cases, septemia in 1 case,hemorrhagic shock in 1 case and secondary bleeding after operation in 3 cases.

结果:采用肝破裂清创缝合止血15例,清创加带蒂大网膜、明胶海绵填塞缝合9例,清创性肝切除7例,纱布填塞3例,肝后下腔静脉、肝静脉主干缝合修补2例。手术治愈29例,治愈率为80.56%,死亡7例,死亡率为19.44%,死于多器官功能障碍综合征3例、败血症1例、失血性休克1例、继发性出血2例。

Growth hormone also plays a role in fighting tissue breakdown, staving off stress fractures and improving metabolic function.

生长激素也发挥了作用,在打击组织破裂,残存的应力性骨折,改善代谢功能。

The result shows that the cruciform specimen with square thinning center region is the superior device for the investigation of forming limit stress diagram to obtain the more homogeneous stress distribution in the center region, to realize the large deformation and the fracture appears in the center region more easily, and to control the stress concentration preferably.

结果表明,中心区方形减薄的十字形试件有更好的中心区应力分布均匀性,更容易实现大变形以致破裂发生在中心区,能较好地控制应力集中,是更适用于板料成形极限应力图研究的实验装备。

Results There were 95 cases of fracture of rib,28 cases of haemothorax,8 cases of hydropneumothorax,8 cases of pneumatothorax,67 cases of pulmonary contusion,18 cases of traumatic pulmonary aerocyst,12 cases of pulmonary hematoma,one case of bronchial rupture and one case of diaphragmatic rupture in our group.

结果 肋骨骨折95例,胸腔积血28例,液气胸8例,气胸8例,肺挫伤67例,创伤性肺气囊18例,肺血肿12例,支气管断裂和膈肌破裂各1例。

These cases included 55 cases of ITP,33 cases of HS,5 cases of MA,5 cases of PHT with splenic function accentuation,3 cases of splenic cyst,1 case of splenic abscess,3 cases of splenic angioma,2 cases of splenic angiolymphoma,2 cases of accessory spleen,and 1 case of splenic rupture.

病例构成为原发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)55例,遗传性球形红细胞增多症(hereditary spherocytosis,HS)33例,地中海贫血(mediterranean anemia,MA)5例,肝硬化门脉高压脾亢5例,脾囊肿3例,脾脓肿1例,脾血管瘤3例,脾淋巴管瘤2例,副脾2例,脾破裂1例。

The abdominal wall in the left lower quadrant, 2 finger breadths (3 cm) cephalad and 2 finger breadths medial to the anterior superior iliac spine, has been shown to be thinner and with a larger pool of fluid than the midline and is usually a good choice for needle insertion for performance of a therapeutic paracentesis.27 The right lower quadrant may be a suboptimal choice in the setting of a dilated cecum or an appendectomy scar.

在过去,常常将腹部正中线耻骨与肚脐中间定为穿刺点,现在,由于腹腔穿刺引流大量液体以及腹中部脂肪厚度增加,左下腹成为腹腔穿刺部位(表1),在左下腹部中线至髂前上棘连线上2指宽(3cm)与距髂前上棘2指宽,已经显示较中部脂肪少及腹水较多是治疗性腹腔穿刺好的首选部位27,在盲肠有扩张或阑尾切除术后瘢痕时右下腹是次选的穿刺部位,应避开腹壁下动脉,这些血管走行在耻骨与髂前上棘之间的中线然后在腹直肌中向上行走,,腹壁可见的侧支循环亦应该避开,腹腔镜检查发现侧支循环可出现在中线并且在腹腔穿刺时有导致血管破裂的风险28。

It is important to judge accurately the trauma extent and range, appraise other organ injuries, carefully explore during operation, thoroughly irrigate peritoneal cavity and intestinal tract, strictly debride and sterilize.

治疗外伤性迟发性结肠破裂重要的是准确判断结肠损伤程度和范围,了解合并损伤的脏器,术中仔细探查,彻底进行肠道和腹腔冲洗,并严格清创和消毒。

ObjectiveTo summarize the clinical experiences of early diagnosis and surgical treatment of traumatic diaphragmatic rupture in 34 patients.

目的总结创伤性膈肌破裂的早期诊断和外科治疗的临床经验。

ConclusionThe early diagnosis and active treatment of complicated injuries is the key to cure the traumatic diaphragmatic rupture.

结论早期诊断和积极治疗是救治创伤性膈肌破裂的关键。

Traumatic diaphragmatic rupture is a disease which severely threatens the human health.

创伤性膈肌破裂是严重威胁人类健康的疾病。

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