闭合性颈段气管断离伤的诊断及治疗（附5例报告）

目的进一步提高闭合性颈段气管断离伤的诊断及治疗水平。方法回顾性分析5例闭合性气管断离伤的临床资料，其中3例气管2～3环全断离，2例3～4环全断离；1例合并腹膜后血肿，1例合并双侧气胸。全部病例均作低位气管切开，气管退缩至胸腔者游离松解后上提，气管断端吻合。外科处理腹膜后血肿及气胸。结果全部病例气管断端吻合口愈合，2周后拔除气管套管，呼吸、进食正常。2例声音嘶哑，为左声带固定。结论及早诊断、正确处理是抢救闭合性颈段气管全断离伤的关键。

Diagnosis and treatment of complete cervical tracheal transection in blunt trauma （5 cases report ）

Objective To discuss the diagnosis and treatment of complete cervical tracheal transection in blunt trauma. Methods Clinical data of 5 cases with complete cervical tracheal transection in blunt trauma was analyzed retrospectively. The transection site was located between the second and the third tracheal annulus in 3 cases, and between the third and the fourth annulus in 2 cases. Combined retroperitoneal hematoma and bilateral pneumatothorax occurred in one case respectively. Low-site tracheotomy was preformed in all cases. The broken tracheal ends which receded to the thoracic cavity were raised and inoseulated with the cervical ends. Retropefitoneal hematoma and pneumatothorax was surgically treated respectively. Results The broken tracheal ends were connected by anastomosis and the tracheal canulas were removed two weeks after operation in all cases. The respiratory and swallowing functions returned to normal in all cases and hoarseness occurred in 2 cases due to fixation of the left vocal cord. Conclusion Early diagnosis and prompt managenent can play a key to rescue the complete ＇cervical tracheal transection in blunt trauma.