颈部外伤的救治(附36例报告)

目的总结颈部外伤临床救治的经验教训,以提高诊疗水平.方法对1990年-2002年诊治的36例颈部外伤进行回顾性分析,其中22例开放性损伤,14例闭合性损伤,手术清创探查25例,其中气管切开9例、Ⅰ期喉成型4例,颈内静脉损伤修补2例,颈外静脉结扎3例,颈外动脉损伤结扎1例,颈总动脉损伤修补1例,甲状腺缝扎3例,保守治疗11例.结果全部患者存活,2例轻度声嘶,1例喉狭窄未能堵管放弃手术治疗,带管出院.其余均恢复正常呼吸,进食功能,语言功能,痊愈出院.结论对颈部外伤的患者应把抢救生命放在首位,并尽可能恢复喉功能和防止并发症,正确处理呼吸困难,出血及休克是治疗成功的关键.

The treatment of cervical trauma

Objective To conclude the clinic experiences in treating cervical trauma and improve the treatment level.Methods 36 cases dingnosed as cervical trauma in 1990-2002 were analysed.Among 36 cases investiguted.open injury and closed injury were 22 cases and 14 cases respectively.25 cases underwent epluchage and exploratory operation 9 eases undersent truchectory.4 caes underwent laryngoplasly I period.2 case underwent intemal jugular wein neoplasty.3 eases underwent external earotid vein ligation.One ease underent exteral carotid artery ligation.One ease underwent common carotid artery neoplary.3 cases underwent drymid suture and 11 cases received conservative treatment.Results all the patients survived 2 cases had mild hoarseness.One rase with larygostenoiss gave up the surgury and was discharged with tracheal catheter.All the other patients reslored hreath food-intake and speech function and recovered.Conclusions Putting it the first palce to rescue the life for cervical trauma.restoring the laryngeal function and preventing complication.treating the dyspnen hemonhage ond shock properly were the keys of suecessful treatment.