【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 对40例胸腹联合伤患者摄取胸腹部X线片、CT扫描及USG检查，以CT测量疝入胸内容物面积、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，面积<10cm 2 ，裂口3～5cm8例(50.0%)，治愈15例(93.8%);Ⅱ组11例，面积10～50cm 2 ，裂口6～10cm5例(45.5%)，治愈9例(81.8%);Ⅲ组10例，面积50～80cm 2 ，裂口11～15cm4例(40.0%)，治愈6例(60.0%);Ⅳ组3例，面积≥80cm 2 ，裂口>16cm2例(66.7%)，术后均见肠及胸膜粘连。结论 CT可100%显示胸腹联合伤所致的膈疝，结合USG可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

    Imaging diagnoses and clinical operations of40cases of compound thorax-abdomen injuries

    Lin Yisheng，Du Xiebin，Guo Yuxin

    Puning Huaqiao Hospital，Guangdong515300.

    【Abstract】 Objective To investigate the imaging diagnostic value of the thoracic diaphragmatic hernias caused by compound thorax-abdomen injuries.Methods 40cases of compound thorax-abdomen injuries were giv-en X-ray films，CT scanning and USG and divided into groupsⅠ，Ⅱ，Ⅲ，Ⅳaccording to the hernia areas in thorax-es measured by the fissure size measured by means of operations and the cured rate.Results Of40cases there were thoracic diaphragmatic hernias in left thoraxes of38cases while in right thoraxes of2cases.The diagnostic rate of CT scanning and X-ray films reached100%and60%respectively.In16cases of groupⅠthe hernia area was less than10square centimetre;the fissure size was from3to5centimetre(50%);15cases were cured(93.7%).In11cases of groupⅡthe hernia area was less than50square centimetre;the fissure size was from6to10centimetre(45.5%);9cases were cured(81.8%).In10cases of groupⅢthe hernia area was less than80square centimetre;the fissure size was from11to15centimetre(40.0%);6cases were cured(60.0%).In3cases of groupⅣthe hernia area was more than80square centimetre;the fissure size was more than16centimetre(66.0%);Intestinal and thoracic diaphragmat-ic adhensions were seen after operations.Conclusions CT scanning can display percent presence of the thoracic di-aphragmatic hernias caused by compound thorax-abdomen injuries.With the help of USG ......