颈部开放性损伤65例

Open wounds of the neck (Report of 65 cases)

颈部开放性损伤的诊断处理是头颈外科面临的一个重要课题。报道颈部开放伤６５例，一期手术探查修复４４例，二期手术１４例，保守治疗７例。辅助检查和手术探查发现，６２例有颈部器官和结构损伤，其中血管损伤１８例，神经损伤９例，咽损伤１８例，喉损伤２１例，气管损伤５例，食管损伤６例，２３例为两种以上器官受损。治疗结果：痊愈５３例，好转９例，死亡３例，分别死于锁骨下动脉损伤，腹部脏器伤和大咽瘘各１例。就其急救，诊断和治疗进行讨论。

Abstract Diagnosis and treatment of open wounds to the neck is an important problem faced to the head and neck surgeon. In this paper, 65 patients with open neck injuries hospitalized in our de-partment were reported.Among them,44 cases underwent primary operative exploration and re-pair,14 secondary operation,7 conservative treatment.With ancillary diagnostic studies and ex-ploratory operation,62 cases were found with organic injuries,including 18 cases with blood ves-sel injuries, 9 nerves,18 pharynx , 21 larynx, 5 trachea, and 6 esophagus. 23 patients were injuried with more than two organs or structure. The result of treatment showed that 53 patients were cured and 3 patients died of subclavian artery injury , abdominal visceral wounds and large pharyngeal fistula , respectively, The first aid ,diagnosis and treatment were discussed.