颈部闭合性损伤诊治分析

Analysis of diagnosis and treatment for blunt trauma in the neck

目的:探讨颈部钝挫伤的器官损伤特点及并发症,CT及超声检查的优势及局限性。方法:回顾性分析颈部钝挫性外伤患者7例的临床资料,给予环杓关节复位术、气管切开术及颈部探查止血等治疗。结果:2例声带麻痹患者治疗后,1例声带旁中位固定,1例环杓关节复位后患者声带外展、内收活动正常;2例会厌水肿患者治愈并拔管;2例甲状腺区肿胀淤血患者,1例因呼吸衰竭死亡,1例治愈;1例颈总动脉栓塞患者死亡。结论:颈部外伤患者在保持呼吸道通畅、有效呼吸、抗休克的情况下,还要注意头部的血液循环。一些辅助喉部检查阴性的患者在伤后数小时内随着病变的进一步发展,会出现颈部肿胀、呼吸困难、神志不清直至死亡。动态监测可以及时了解患者病情变化,为治疗争取时间。

Objective： ：To explore the organ damage character and complications of blunt trauma in the neck , and the advantage and disadvantage of CT and ultrasound for blunt trauma in the neck. Method：The data of 7 neck blunt trauma cases was analyzed. Cricoarytenoid joint reduction, tracheotomy, exploratory surgery of neck were performed respectively for these cases. Result： Of the 2 cases with vocal cord paralysis, one had his vocal cords fixed in the the para-median position, one had his vocal cords move freely. 2 cases of epiglottis edema had been cured. Among the 2 cases of thyroid area swelling and congestion, one died from respiratory failure, one was cured. One case died of carotid artery embolism. Conclusion： Circulation of the head should be noticed as well as keeping respiratory tract clear and anti-shock treatment. Some patient with negative laryngeal examinations might get worse in the following hours, and swelling of the neck, dyspnea, obnubilation may appear in these cases. Dy- namic monitoring could be helpful for the diagnosis and treatment of neck blunt trauma.