颈动脉外伤处理原则

Management principles of carotid artery trauma

颈动脉外伤致伤原因多样,发病凶险,救治困难,致死、致残率高。与四肢动脉损伤不同,颈动脉所在地处"解剖要道",内侧相邻气管、食管、颈静脉,形成的血肿易压迫气管引起窒息;靶器官大脑非常重要,损伤引起大脑缺血,极易致残甚至死亡;周围还有迷走、舌下等重要颅神经,损伤本身或救治过程中保护不佳极易造成继发损伤,引起严重神经并发症;且颈动脉位置表浅、暴露于躯干以外,不易防护,容易受到创伤。颈动脉外伤救治属于临床公认难题,相关研究报道较少。建议基于"TOPIC"分型,对颈动脉外伤实施"ABC"救治原则。

Carotid artery trauma has various causes with dangerous incidence,high mortality and disability rate.Different from limb arterial injury,the neck where the carotid artery located is in the"anatomical key points".The inner side is adjacent to the trachea,esophagus,and jugular vein.The formed hematoma could easily compress the trachea and cause suffocation.The target organ brain is very important,and the damage could cause cerebral ischemia.It is extremely vulnerable to disability or even death.There are also important cranial nerves such as vagus and sublingual.The injury itself or poor protection during the treatment process could easily cause secondary damage and cause serious neurological complications.The location of carotid artery is superficial and exposed outside the trunk,which is not easy to protect and easy to be injured.The treatment of carotid artery trauma is a clinically recognized problem,and there are few related research reports.It is proposed the principle of"ABC"treatment of carotid artery trauma based on the"TOPIC"classification.