探讨腹腔镜下膈肌折叠术在成人膈膨升中的应用价值。

回顾性分析2018年1月至2024年6月中山大学附属第六医院收治的10例成人膈膨升患者的临床资料。所有患者均接受腹腔镜下膈肌折叠术，包括标准化的穿刺套管布局、膈肌切开、折叠缝合、补片加强修补及术后管理。术后随访1年，观察症状缓解情况、肺功能改善情况及复发率。

10例患者均顺利完成手术，手术时间90~180 min（平均130 min），术中出血量15~40 ml，术后住院时间7~9 d。术后肺功能指标[用力肺活量、第一秒用力呼气容积]提升25%~40%。随访1年无解剖学复发，膈肌位置稳定。1例肥胖患者（体重指数32 kg/m²）术后仍存在轻度活动后气促。

腹腔镜下膈肌折叠术是一种安全、有效的微创治疗方案，可显著改善成人膈膨升患者的临床症状和肺功能，且短期随访无复发。该技术为膈膨升的治疗提供了新的策略选择。然而，由于样本量小、缺乏对照组且随访时间较短，其远期疗效和补片应用的安全性仍需通过大样本、长期随访研究进一步验证。

To explore the application value of laparoscopic diaphragmatic plication in adults with diaphragmatic eventration.

A retrospective analysis was conducted on the clinical data of 10 adult patients with diaphragmatic eventration treated at The Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2024. All patients underwent laparoscopic diaphragmatic plication which included standardized trocar placement, diaphragmatic incision, plication and suture, mesh reinforcement, and postoperative management. Patients were followed up for 1 year to observe symptom relief, pulmonary function improvement, and recurrence rate.

All 10 patients successfully completed the surgery, with an operative time ranging from 90 to 180 minutes (mean, 130 minutes), intraoperative blood loss of 15-40 ml, and postoperative hospital stay of 7-9 days. The pulmonary function indicators (forced vital capacity, forced expiratory volume in one second) significantly improved by 25%-40%. No anatomical recurrence was observed during the 1-year follow-up, and diaphragmatic position remained stable. However, one obese patient (body mass index 32 kg/m²) still experienced mild dyspnea after activity postoperatively.

Laparoscopic diaphragmatic plication is a safe and effective minimally invasive treatment option that significantly improves clinical symptoms and pulmonary function in patients with adult diaphragmatic eventration, with no recurrence observed in short-term follow-up. This technique provides a new strategy for the treatment of diaphragmatic eventration. However, due to the small sample size, lack of a control group, and short follow-up duration, the long-term efficacy and safety of mesh application need to be further verified through large-sample, long-term follow-up studies.