Nasr Adonis, de Oliveira Jéssica Tamara, Mazepa Melissa Mello, de Albuquerque Christine Lima Cavalcanti, Martini Gabriela Soraya, Nazario Mariana, de Carvalho Fábio Henrique
Universidade Federal do Paraná, PR, Brazil.
Universidade Positivo, PR, Brazil.
Rev Col Bras Cir. 2015 Jul-Aug;42(4):215-9. doi: 10.1590/0100-69912015004004.
the study has the intention of evaluate the accuracy of computed tomography for the diagnosis of cervical lesions on penetrating neck trauma and also identify the most frequent mechanisms of trauma. Most injured structures, determine the age range and the most prevalent sex.
observational descriptive retrospective study executed by the systematic retrospective review of medical records of all patients victims of penetrating neck trauma that went through surgery and CT scans, admitted into Hospital do Trabalhador, between January 2009 and December 2013.
the final sample was of 30 patients, 96.7% of the male sex, the median age was of 28 years old. Most patients suffered injuries by gun (56.7%) and 33,3% suffered stab wounds. The most stricken area of the neck was Zone II (77.8%) and the left side (55.2%). Regarding the structures injured, the CT showed 6.7% lesions on airways but the surgery showed 40% of damaged, with a value of p=0.002. As to damages of the esophagus and pharynx the CT detected 10% of lesions, while surgery found 30% of lesions, therefore with a significant value of p=0.013. As for the analysis the CT showed reliable. As for the analysis of vascular damage, the CT showed to be, in most cases, reliable to the findings during the surgical act.
besides the great use of CT for the diagnosis of penetrating neck injuries we can say that this is an exam with low accuracy for the diagnosis of lesions of aerodigestive tract, therefore it is important a clinical correlation for a good diagnosis.as for the vascular lesions and of other structures, the CT had high sensibility and specificity, thus a good exam to be used in overall.
本研究旨在评估计算机断层扫描（CT）对穿透性颈部创伤中颈部病变诊断的准确性，并确定最常见的创伤机制、最常受损的结构、确定年龄范围和最普遍的性别。
通过对2009年1月至2013年12月期间入住劳工医院、接受手术和CT扫描的所有穿透性颈部创伤患者的病历进行系统回顾性分析，开展观察性描述性回顾性研究。
最终样本为30例患者，男性占96.7%，中位年龄为28岁。大多数患者因枪伤（56.7%）受伤，33.3%为刺伤。颈部最常受伤的区域是Ⅱ区（77.8%）和左侧（55.2%）。关于受损结构，CT显示气道病变为6.7%，但手术显示受损率为40%，p值为0.002。至于食管和咽部损伤，CT检测到10%的病变，而手术发现30%的病变，因此p值具有显著意义，为0.013。至于分析，CT显示可靠。对于血管损伤的分析，CT在大多数情况下与手术过程中的发现可靠。
除了CT在诊断穿透性颈部损伤方面的广泛应用外，我们可以说，对于气消化道病变的诊断，这项检查的准确性较低，因此良好的诊断需要临床关联。至于血管病变和其他结构，CT具有较高的敏感性和特异性，因此总体上是一项很好的检查。
