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颈部创伤:耳鼻喉科展望

Neck Trauma: ENT Prospects.

作者信息

Sachdeva Kavita, Upadhyay Aparaajita

机构信息

Department of E.N.T., NSCB Medical College, Jabalpur, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):52-57. doi: 10.1007/s12070-016-1048-3. Epub 2017 Jan 4.

Abstract

Neck trauma is a very important surgical emergency faced by ENT surgeons in day to day practice. They are potentially life threatening conditions due to the presence of many vital structures in this area. Timely presentation to the referral centre and proper multidisciplinary approach towards management plays a pivotal role in the healing pattern of the wound and prevention of serious complication like shock, sepsis, laryngeal stenosis or fistula formation. A retrospective study was done in ENT Department, NSCB Medical College, Jabalpur, Madhya Pradesh, India during the period of 2014-2016. 17 patients were included in the study. All the records regarding symptoms at presentation, type and mode of injury, level of injury were analyzed. Management plan undertaken were thoroughly studied and post operative complications like hoarseness, stenosis or fistula formation were noted carefully. 14 out of 17 patients were male, all 17 patients belonged to lower socioeconomic status. Most common age group presenting with neck trauma was between 22 and 40 years. 7 case were homicidal, 5 cases were suicidal and 4 were of accidental injury. Most cases reached hospital within 2-6 h of injury except 3 cases which took more than 8 h. Bleeding from wound site was most common symptom at presentation. Most injuries in 13 out of 17 cases were at thyroid cartilage level. Penetrating neck trauma was most common followed by blunt neck trauma. Most cases required emergency tracheostomy along with primary laryngotracheal repair. Most common post operative complication seen was wound dehiscence, subglottic stenosis and fistula formation. Neck trauma and cut throat injuries are potentially life threatening emergency that require multidisciplinary approach. Timely intervention can be crucial in preventing fatal complications and reducing morbidity period of the patient.

摘要

颈部创伤是耳鼻喉科医生在日常临床工作中面临的非常重要的外科急症。由于该区域存在许多重要结构,这些情况可能危及生命。及时转诊至转诊中心并采取适当的多学科管理方法,对伤口的愈合模式以及预防诸如休克、脓毒症、喉狭窄或瘘管形成等严重并发症起着关键作用。2014年至2016年期间,在印度中央邦贾巴尔普尔市NSCB医学院耳鼻喉科进行了一项回顾性研究。该研究纳入了17例患者。对所有关于就诊时症状、损伤类型和方式、损伤部位的记录进行了分析。对所采取的管理计划进行了全面研究,并仔细记录了术后并发症,如声音嘶哑、狭窄或瘘管形成。17例患者中有14例为男性,所有17例患者均属于社会经济地位较低的群体。出现颈部创伤的最常见年龄组在22岁至40岁之间。7例为他杀,5例为自杀,4例为意外伤害。除3例受伤后超过8小时才到达医院外,大多数病例在受伤后2至6小时内到达医院。伤口部位出血是就诊时最常见的症状。17例病例中有13例的大多数损伤位于甲状软骨水平。穿透性颈部创伤最为常见,其次是钝性颈部创伤。大多数病例需要紧急气管切开术并进行一期喉气管修复。最常见的术后并发症是伤口裂开、声门下狭窄和瘘管形成。颈部创伤和割喉伤是潜在的危及生命的急症,需要多学科方法处理。及时干预对于预防致命并发症和缩短患者的发病期可能至关重要。

相似文献

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Neck Trauma: ENT Prospects.颈部创伤:耳鼻喉科展望
Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):52-57. doi: 10.1007/s12070-016-1048-3. Epub 2017 Jan 4.
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