diaphragmatic hernia repair

1. The diagnosis of injury sputum should be treated surgically. 2. Congenital sputum has no obvious symptoms in clinical practice, but it can be operated after a little older age; if there is intestinal obstruction or pyloric obstruction, emergency surgery can be performed after fasting and gastrointestinal decompression symptoms are not relieved; if heart or lung compression occurs Symptoms, such as palpitation, shortness of breath, cough, chest tightness, difficulty breathing, and even cyanosis, regardless of age, should be treated early. Treatment of diseases: mediastinum Indication 1. The diagnosis of injury sputum should be treated surgically. 2. Congenital sputum has no obvious symptoms in clinical practice, but it can be operated after a little older age; if there is intestinal obstruction or pyloric obstruction, emergency surgery can be performed after fasting and gastrointestinal decompression symptoms are not relieved; if heart or lung compression occurs Symptoms, such as palpitation, shortness of breath, cough, chest tightness, difficulty breathing, and even cyanosis, regardless of age, should be treated early. Preoperative preparation 1. Correct dehydration, electrolyte imbalance and acid-base balance disorders. 2. Apply antibiotics to control infection. 3. Can lose whole blood, plasma or albumin, correct anemia and low protein. 4. Place the gastric decompression tube and aspirate the contents of the stomach to reduce the pressure on the heart and lungs and prevent postoperative abdominal distension. 5. Patients with shortness of breath, difficulty breathing, and cyanosis should remove respiratory secretions before surgery and give oxygen. 6. Injury should pay attention to the treatment of complex injury, if there is shock, active blood transfusion, fluid replacement therapy for shock (see pleural fibrectomy). Surgical procedure 1. Position, incision: right lateral position, left lateral incision, adult into the chest through the 8th ribbed bed, children through the 8th intercostal chest. 2. Reconstruct the contents of the sputum: use the suction device to absorb the blood or effusion in the chest cavity, and perform a systematic examination on the internal organs of the chest and the abdominal organs that are inserted into the chest. If the organ is found to be ruptured or bleeding, it can be sutured and repaired. And stop bleeding. In the early cases, the stomach, intestines, omentum, and other invading organs are easily returned to the abdominal cavity. If it is difficult to reset, the adhesion can be separated, the fistula can be cut open, and the invaded abdominal organ can be reset. 3. Repair the pupil: Anatomize the diaphragm around the ankle and suture it with a 7-gauge thread. It can also be sutured intermittently, and the second layer of suture is used for folding suture. If the defect is too large, the suture is directly sutured. The defect can be repaired with a suitable size of polyester cloth or autologous fascia, sutured continuously, and then stabilized with intermittent suture. 4. Close the chest: Place the closed thoracic drainage, repeatedly flush the chest cavity, and suture the chest wall layer by layer. Congenital hernia repair in children can also be repaired through the abdominal incision, because the rib angle of the child is blunt, the rib arch is soft, easy to expose, and the abdominal organs and the greater omentum that are inserted into the chest cavity are included in the abdominal cavity, and the pupil is repaired. The 7th silk thread was intermittently folded and sutured, and the closed thoracic drainage was performed, and the abdomen was sutured.

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