胸骨缺陷部位可见一大小约10*15cm2的易复性疝一例

       患者，男，55岁，有糖尿病，主诉严重反流、慢性咳嗽、吸入性肺炎等症状。胸骨缺陷部位可见一大小约10*15cm2的易复性疝 。（如图A）。
患者于3年前行冠状动脉旁路移植术，开胸手术造成的胸骨创伤愈合不良。术后进行了伤口清理、胸骨切口缝合及拆线，并按照开放性损伤进行护理，直到放置了大网膜瓣使伤口得以闭合。
       计算机断层扫描（CT）显示，胃疝通过胸骨缺陷向前脱出（如图B）。鉴于手术修复的复杂性和患者可与疝气共存的现状，采取保守方案，予以减肥术和质子泵抑制剂（PPI）治疗，继以疝带固定维持。
       7个月后，患者无明显不适症状，且无相关并发症发生。
       原文：

Images in Clinical Medicine

Transsternal Gastric Hernia

Eoin Daniel O'Sullivan, M.B., and Sarah Margaret Moran, M.B.

N Engl J Med 2014; 370:1440April 10, 2014DOI: 10.1056/NEJMicm1309719

A 55-year-old man with diabetes presented with severe reflux, chronic cough, and aspiration pneumonia. An easily reducible hernia measuring 10 cm by 15 cm was noted in the area of the sternal defect (Panel A). Three years earlier, he had undergone coronary-artery bypass grafting, which was complicated by impaired sternal wound healing. Débridement was performed, sternotomy wires were removed, and care was provided for the open wound until an omental flap could be placed to achieve wound closure. Computed tomography of the thorax revealed anterior gastric herniation through the defect (Panel B). Given the complexity of the surgical repair required and the patient's coexisting conditions, a conservative approach of weight loss, treatment with a proton-pump inhibitor, and the use of a truss was pursued. At 7 months, the patient was asymptomatic and free of further complications.




Eoin Daniel O'Sullivan, M.B.
Sarah Margaret Moran, M.B.
Cork University Hospital, Cork, Ireland

“采取保守方案，予以减肥术和质子泵抑制剂（PPI）治疗”该处的减肥术应翻译为体重控制或者减肥。

lorac 发表于 2014-5-17 16:38
“采取保守方案，予以减肥术和质子泵抑制剂（PPI）治疗”该处的减肥术应翻译为体重控制或者减肥。

谢谢译注

感觉修补好

这个可不好修补啊

来看看楼上答案学习

来看看高手解答

来看看高手解答

来看看高手解答

bianxingmifeng 发表于 2014-10-7 14:04
这个可不好修补啊

确实如此！