Barkana Y, Stein M, Scope A, Maor R, Abramovich Y, Friedman Z, Knoller N
Surgeon General Headquarters, Medical Corps, Israel Defense Forces, Israel.
Injury. 2000 Jun;31(5):305-9. doi: 10.1016/s0020-1383(99)00298-3.
The purpose of this study was to assess the specific indications, benefits and risks associated with cervical spine stabilization during pre-hospital care of penetrating neck injuries. We retrospectively reviewed hospital charts and autopsy reports of 44 military casualties in Israel with a penetrating neck injury during a period of 4.5 years. A review of the literature was also carried out. In eight of 36 hospitalized casualties (22%) a life-threatening sign was diagnosed in the exposed neck - large or expanding haematoma, or subcutaneous emphysema. Surgical stabilization of the cervical spine was not performed for any of the casualties. It was concluded that life threatening complications due to penetrating neck injury are common and may be overlooked if the neck is covered by a stabilization device. It is extremely rare for a penetrating injury to result in an unstable cervical spine. New management guidelines concerning pre-hospital stabilization are suggested.
本研究的目的是评估穿透性颈部损伤的院前护理期间颈椎稳定术的具体适应症、益处和风险。我们回顾性分析了4.5年间以色列44例穿透性颈部损伤军事伤亡人员的医院病历和尸检报告。同时也进行了文献综述。在36例住院伤亡人员中，有8例（22%）在暴露的颈部诊断出危及生命的体征——大血肿或不断扩大的血肿，或皮下气肿。所有伤亡人员均未进行颈椎手术固定。得出的结论是，穿透性颈部损伤导致的危及生命的并发症很常见，如果颈部被固定装置覆盖，可能会被忽视。穿透性损伤导致颈椎不稳定极为罕见。建议制定有关院前固定的新管理指南。
