胸腹联合伤影像诊断与临床手术（附40例分析）

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1、胸腹联合伤影像诊断与临床手术（附40例分析）【关键词】胸腹联合伤【摘要】目的探讨影像学对胸腹联合伤所致胸内膈疝的诊断价值。方法対40例胸腹联合伤患者摄取胸腹部X线片、CT扫描及USG检杳，以CT测量疝入胸内容物面枳、手术测量其裂口大小，据此分为4组观察临床治愈率。结果I组16例，而积＜10cm2,裂口3〜5cm8例(50.0%),[險15例(93.8%);11组11例,而积10〜50cm2,裂口6〜10cm5例(45.5%),漁I9例(81.8%);111组10例面积50〜80cm2，裂□11〜15cm4例(40.0%),治愈6例(60.0%);IV组3例，血积N80cm2,裂口＞16cm2

2、例(66.7%),术后均见肠及胸膜粘连。结论CTnJ'100%显示胸腹联合伤所致的膈疝，结合USG对明确诊断合并伤及判断横膈破裂口的部位及大小，为临床手术提供可靠帮助。关键词胸腹联合伤膈疝体层摄影术X线计算机Imagingdiagnosesandclinicaloperationsof40casesofcompoundthorax-abdomeninjuriesLinYisheng,DuXiebin,GuoYuxinPuningHuaqiaoHospital,Guangdong515300.【Abstract]ObjectiveToinvestigatetheimagingdiagnosti

3、cvalueofthethoracicdiaphragmaticherniascausedbycompoundthorax-abdomeninjuries.Methods40casesofcompoundthorax-abdomeninjuriesweregiv-enX-rayfilms,CTscanningandUSGanddividedintogroupsI＞ILIII,I*accordingtotheherniaareasinthorax-esmeasuredbythefissuresizemeasuredbymeansofoperationsandthecuredrate.Resu

4、ltsOf40casestherewerethoracicdiaphragmaticherniasinleftthoraxesof38caseswhileinrightthoraxesof2cases.ThediagnosticrateofCTscanningandX-rayfilmsreached100%and60%respectively.ln16casesofgroupItheherniaareawaslessthanlOsquarecentimetre;thefissuresizewasfrom3to5centimetre(50%);15caseswerecured(93.7%).I

5、nileasesofgroupIItheherniaareawaslessthan50squai*ecentimetre;thefissuresizewasfrom6to1Ocentimetre(45.5%);9caseswerecured(81.8%).InlOcasesofgroupllltheherniaareawaslessthan80squarecentimetre;thefissuresizewasfrom11to15centimetre(40.0%);6caseswerecured(60.0%).In3casesofgrouplVtheherniaareawasmorethan

6、80squarecentimetre;thefissuresizewasmorethanl6centimetre(66.0%);Intestinalandthoracicdiaphragmat-icadhensionswereseenafteroperations.ConclusionsCTscanningcandisplaypercentpresenceofthethoracicdi-aphragmaticherniascausedbycompoundthorax-abdomeninjuries.WiththehelpofUSG,doctorscanconfinnthedi-agnoses

7、andunderstandthelocationandsizeoffissuresinordertoofferreliableinformationforoperations・Keywordsthorax-abdomeninjurydiapliragmaticherniatomographyX-raycomputed穿透性膈肌伤及钝性膈肌伤致膈肌破裂腹腔内脏器官疝入胸内的胸腹联合你为外科的常见病之一，约占胸腹