成人膈疝的诊断与治疗策略
Diagnosis and treatment of adult diaphragmatic hernia
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摘要: 成人膈疝的病因主要包括先天性及创伤性,其总体发病率较低,临床表现缺乏特异性,易误诊、漏诊,诊断与治疗尚无临床指南与共识。笔者总结国内外相关文献,结合临床实践,探讨成人膈疝的诊断与治疗策略:建议疑似患者及时完善多排螺旋CT检查,关注矢状位影像;有临床症状者应及时修补缺损,择期手术优先选择经腹入路腹腔镜手术,对于缺损较大者推荐补片加强修补。Abstract: The etiology of diaphragmatic hernia in adults is mainly congenital and traumatic, its overall incidence in adults is low, and adult diaphragmatic hernia is easily misdiagnosed and missed diagnosis because of lacking specificity in clinical presentation. There is no clinical guidelines or consensus for the diagnosis and treatment of diaphragmatic hernia in adults. The authors inquire into the diagnosis and treatment of diaphragmatic hernia in adults by summarizing relevant litera-tures and combining with clinical practice, and recommend that multi‑slice spiral computed tomo-graphy should be promptly refined for suspected cases, especially focusing on sagittal images. The symptomatic patients should be repaired promptly, with a preference for laparoscopic surgery, and mesh augmentation is recommended in those with larger defects.