Tunçyürek P, Cabbarpur C, Aksu H
Başkent Universitesi Zübeyde Hanim Uygulama ve Araştirma Merkezi 6371 sok. No: 34 Bostanli/Izmir.
Ulus Travma Derg. 2001 Jul;7(3):204-6.
A 30 year old man is admitted to the emergency section with the complaint of bleeding from the neck after an industrial explosion. A laceration, 5 cm's in length, is seen on 'zone II', near the medial border of the anterior jugular triangle. The patient was hemodynamically stable, but there was active bleeding from the laceration. A round mass is detected with palpation adjacent to the bifurcation of carotis. The wound is explored under anesthesia with endotracheal intubation. Major vessels and other vital structures found to be undamaged. Many authors suggest mandatory exploration for the neck wounds that penetrated the platysma, while others prefer exploration for selected cases on the basis of diagnostic studies. Immediate exploration is indicated in the presence of active bleeding, and diagnostic studies should be reserved for haemodynamically stable patients. Injury of major vessels might be tamponaded by foreign bodies, therefore blind removal of the objects may cause life-threatening hemorrhage. Endotracheal intubation is appropriate in the management of airway, as for convenient surgical approach.
一名30岁男性因工业爆炸后颈部出血被送往急诊科。在前颈静脉三角内侧缘附近的“二区”可见一处5厘米长的裂伤。患者血流动力学稳定,但裂伤处有活动性出血。触诊发现颈动脉分叉处附近有一圆形肿物。在气管插管全身麻醉下对伤口进行探查。发现主要血管和其他重要结构未受损。许多作者建议对穿透颈阔肌的颈部伤口进行强制性探查,而另一些人则倾向于根据诊断性检查对特定病例进行探查。存在活动性出血时应立即进行探查,而诊断性检查应保留给血流动力学稳定的患者。主要血管损伤可能被异物压迫,因此盲目取出异物可能导致危及生命的出血。气管插管适用于气道管理,以便于手术操作。