目的 分析創傷性膈疝的診斷、外科治療和預后。 方法 對1999年1月-2010年1月收治的16例創傷性膈疝的臨床資料進行回顧性分析。 結果 16例均行手術治療，胸腹腔臟器損傷處理后行膈肌修補，2例手術后死亡，14例痊愈出院。 結論 創傷性膈疝常合并多發傷，胸腹部X線平片、鋇餐檢查及胸部、上腹部ＣＴ掃描不僅能對膈疝做出正確的診斷，對臨床手術指導具有重要的意義。診斷一旦明確，須及時手術治療，方能降低病死率。
Objective To evaluate the application of surgical strategies for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) involving the C2 segment. Methods The literature about the surgery for cervical OPLL involving C2 segment was reviewed, and the indications, advantages, and disadvantages of surgery were summarized. Results For cervical OPLL involving the C2 segments, laminectomy is suitable for patients with OPLL involving multiple segments, often combined with screw fixation, and has the advantages of adequate decompression and restoration of cervical curvature, with the disadvantages of loss of cervical fixed segmental mobility. Canal-expansive laminoplasty is suitable for patients with positive K-line and has the advantages of simple operation and preservation of cervical segmental mobility, and the disadvantages include progression of ossification, axial symptoms, and fracture of the portal axis. Dome-like laminoplasty is suitable for patients without kyphosis/cervical instability and with negative R-line, and can reduce the occurrence of axial symptoms, with the disadvantage of limited decompression. The Shelter technique is suitable for patients with single/double segments and canal encroachment >50% and allows for direct decompression, but is technically demanding and involves risk of dural tear and nerve injury. Double-dome laminoplasty is suitable for patients without kyphosis/cervical instability. Its advantages are the reduction of damage to the cervical semispinal muscles and attachment points and maintenance of cervical curvature, but there is progress in postoperative ossification. Conclusion OPLL involving the C2 segment is a complex subtype of cervical OPLL, which is mainly treated through posterior surgery. However, the degree of spinal cord floatation is limited, and with the progress of ossification, the long-term effectiveness is poor. More research is needed to address the etiology of OPLL and to establish a systematic treatment strategy for cervical OPLL involving the C2 segment.