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目的分析儿童急性创伤性膈肌破裂临床误诊率较高的原因，提高早期诊断率；方法回顾性分析２８６例儿童胸、腹外伤临床病历，记录临床表现，首诊误诊率（误诊例数／总例数×１００％）及术前误诊率等，并分析误诊原因；结果发现膈肌破裂１４列，首诊误诊率７１．４３％，术前误诊率３５．７１％。结论常有严重的合并症，临床表现差异大等是误诊率较高的原因；降低误诊率要重视膈肌破裂的临床表现，早期行胸腹Ｘ线检查和术中注意膈肌的探查。
Objective To analyze the causes of high misdiagnosis rate of children with acute traumatic diaphragmatic rupture and to improve the early diagnosis rate. Methods The clinical records of 286 children with chest and abdominal trauma were retrospectively analyzed. The clinical manifestations, the first misdiagnosis rate Number × 100%) and misdiagnosis rate before operation. The causes of misdiagnosis were analyzed. Results showed that 14 cases had diaphragmatic rupture, the first misdiagnosis rate was 71.43% and the preoperative misdiagnosis rate was 35.71%. Conclusion Often, serious complications and large differences in clinical manifestations are the reasons for the higher misdiagnosis rate. To reduce the rate of misdiagnosis, the clinical manifestations of diaphragmatic rupture should be emphasized. The thoracoabdominal X - ray examination and intraoperative diaphragmatic examination should be conducted early.