颈部外伤的诊治体会

目的回顾性分析颈部外伤患者的临床资料，对其发病原因、诊断及治疗过程进行分析，总结经验与体会。方法收集南京市第一医院耳鼻咽喉科2008年9月～2017年9月收治的颈部外伤患者19例，其中男15例，女4例；年龄18～87岁，平均年龄46.4岁，病程0.5 h至2个月。１９例患者中颈部异物9例（6例金属异物、3例玻璃异物）、开放性颈部外伤8例、闭合性颈部外伤2例。根据患者不同的发病原因及病情，选择不同的麻醉方式及治疗方法。结果19例患者伤口均愈合良好，随访6个月，无死亡病例，无气管及食管瘘，仅1例并发一定程度的声音嘶哑。结论在颈部外伤的诊治中，保持呼吸道通畅、止血、纠正失血性休克是关键，其次进行异物清除、喉气管功能重建及血管、神经吻合，减少术后功能损失。     

Unusual hyperpigmented patches,an undeveloped breast and a cataract in a female with incontinentia pigmenti

A 19‐year‐old female and her mother visited our department with a history of unusual reticular brown‐black patches on their trunks and limbs since infancy. Besides the obviously fulsome hyperpigmentation, the daughter also showed other unusual clinical manifestations such as generalized hypohidrosis, especially on the hyperpigmented patches, cicatricial alopecia, a cataract on her right eye, abnormal teeth and a right dysplastic breast. The mother had a median diastema between her maxillary central incisors, hypoplasia of the enamel, hypohidrosis and hyperpigmented patches on her left thoracic region. Analysis of the NEMO (NF‐κB essential modulator) gene in the patient and her mother revealed a deletion of exons 4–10. Their EDA and EDAR genes were normal.