Al-Thani Hassan, El-Menyar Ayman, Mathew Sharon, Khawar Mahwish, Asim Mohammad, Abdelrahman Husham, Peralta Ruben, Parchani Ashok, Zarour Ahmad
Department of Surgery, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar.
Trauma Surgery, Clinical Research, Hamad Medical Corporation, Doha, Qatar ; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
J Emerg Trauma Shock. 2015 Jul-Sep;8(3):154-8. doi: 10.4103/0974-2700.160723.
We aimed to analyze the pattern and outcome of traumatic neck injury (TNI) in a small population.
It is a retrospective analysis of all TNI patients who were admitted to the trauma center between 2008 and 2012. Patients' demographics, details of TNI, associated injuries, hospital course, and mortality were analyzed.
A total of 51 TNI cases were included revealing an overall incidence of 0.61/100,000 population. The mean age was 31 ± 9 years. The most frequent mechanism of injury was motor vehicle crash (29.4%) followed by stab (17.6%), machinery injury (17.6%), fall (9.8%), and assault (7.8%). Larynx, thyroid gland, trachea, jugular veins, and carotid were the commonly injured structures. The majority of cases had Zone II TNI whereas isolated injury was observed in 11 cases. TNI were mainly presented with active bleeding (38%), hypovolemic shock (16%) and respiratory distress (16%). Surgical interventions mainly included simple repair and closure (53%), vein ligation (12%), repair of major arteries (4%), tracheal repair (6%), larynx and hypopharynx repair (4%), and repair of parotid gland (2%). Neck exploration was performed in 88%, and emergency tracheostomy was required in 18% of cases. Overall mortality rate was 11.8%, of which five patients had associated injuries, and one had isolated TNI.
TNI are not frequent but represent an alarming serious entity in Qatar. Patients with persistent signs of major injuries should undergo early operative interventions. Moreover, the effective injury prevention program should be developed to minimize these preventable injuries in the majority of cases.
我们旨在分析一小部分人群中创伤性颈部损伤(TNI)的模式及结果。
这是一项对2008年至2012年间入住创伤中心的所有TNI患者的回顾性分析。分析了患者的人口统计学资料、TNI的详细情况、相关损伤、住院过程及死亡率。
共纳入51例TNI病例,总体发病率为0.61/100,000人口。平均年龄为31±9岁。最常见的致伤机制是机动车碰撞(29.4%),其次是刺伤(17.6%)、机械损伤(17.6%)、跌倒(9.8%)和袭击(7.8%)。喉、甲状腺、气管、颈静脉和颈动脉是常见的受伤结构。大多数病例为Ⅱ区TNI,而11例为孤立性损伤。TNI主要表现为活动性出血(38%)、低血容量性休克(16%)和呼吸窘迫(16%)。手术干预主要包括单纯修复和缝合(53%)、静脉结扎(12%)、大动脉修复(4%)、气管修复(6%)、喉和下咽修复(4%)以及腮腺修复(2%)。88%的病例进行了颈部探查,18%的病例需要紧急气管切开术。总体死亡率为11.8%,其中5例患者伴有其他损伤,1例为孤立性TNI。
TNI在卡塔尔并不常见,但却是一个令人担忧的严重情况。有严重损伤持续体征的患者应尽早接受手术干预。此外,应制定有效的损伤预防计划,以在大多数情况下尽量减少这些可预防的损伤。