颈部外伤的临床特点及救治

目的:探讨颈部外伤的特点和救治经验。方法:回顾我院近8年收治的31例颈部外伤患者的临床资料,主要治疗包括气管切开、保持呼吸道通畅、抗休克、妥善止血、食管修补、喉成形及保守治疗等。结果:25例顺利治愈,2例遗留声音嘶哑;1例颈食管瘘经局部换药、清创缝合治愈,1例术后食管狭窄在胃镜下行气囊扩张2次治愈;2例来医院途中分别死于休克和窒息。结论:严重颈部外伤常危及病人生命,在救治中,气管切开、保持呼吸道通畅、及时止血、抗休克、食管修补非常重要;尽可能恢复喉功能和防止呼吸道狭窄等并发症。

Characteristics and treatment of neck trauma

Objective：To discuss the clinic characteristics,and treatment of neck trauma. Methods： 31 cases diagnosed as neck trauma in 2001~2009 were analysed retrospectively. The main treatment included trachectony, keeping airway unobstructed, stanching, preventing shock, mending esophagus, laryngoplasty and conservative treatment. Results..25 cases were cured successfully. 2 cases still had hoarseness. 1 case neck esophageal fistula healed after local changing dressing and later debridement and suturing. 1 case postoperative esophageal stricture healed by twice balloon dilatation through gastroscopy. 2 cases respectively died of shock and asphyxia on the way to hospital. Conclusion ： Severe neck trauma offten imperils patient＇s life. Trachectony, keeping airway unobstructed, stanching, preventing shock,mending esophagus and laryngoplasty are the keys of successful treatment of neck trauma. Restoring the laryngeal function and precluding airway stricture should also be considered as far as possible.