椎动脉穿透性刺伤的治疗策略：一例病例报告
Treatment strategy for a penetrating stab wound to the vertebral artery: a case report.
作者信息
Yaguchi Shinya, Yamamura Hitoshi, Kamata Kousuke, Shimamura Norihito, Kakehata Shinya, Matsubara Atsushi
机构信息
Department of Disaster and Critical Care Medicine School of Medicine Hirosaki University Hirosaki Aomori Japan.
Department of Neurosurgery School of Medicine Hirosaki University Hirosaki Aomori Japan.
出版信息
Acute Med Surg. 2018 Nov 28;6(1):83-86. doi: 10.1002/ams2.381. eCollection 2019 Jan.
CASE
Vertebral artery injury is a low-frequency but high-mortality injury. The surgical approach to a bleeding vertebral artery injury is one of the most difficult procedures in trauma surgery.A 64-year-old woman was transported to our emergency department after being stabbed in the middle side of the right neck with a large kitchen knife. Her initial hospital examination indicated a shock state, and computed tomography images revealed a right vertebral artery injury. We undertook angiography and transcatheter arterial embolization before the surgical operation.
OUTCOME
The patient suffered right upper extremity paralysis due to brachial plexus injury and was transferred to another hospital for rehabilitation on the 24th hospital day.
CONCLUSION
Computed tomography angiography for diagnosis and interventional radiology treatment are useful for the management of penetrating neck trauma. Transcatheter arterial embolization for vertebral artery injury is safe and allows for easy control of bleeding compared to a surgical procedure.
病例
椎动脉损伤是一种低频但高死亡率的损伤。出血性椎动脉损伤的手术方法是创伤外科中最困难的手术之一。一名64岁女性被一把大菜刀刺伤右颈部中部后被送往我们的急诊科。她最初的医院检查显示处于休克状态，计算机断层扫描图像显示右侧椎动脉损伤。我们在手术前进行了血管造影和经导管动脉栓塞术。
结果
患者因臂丛神经损伤导致右上肢瘫痪，并在住院第24天转至另一家医院进行康复治疗。
结论
计算机断层扫描血管造影用于诊断和介入放射学治疗对穿透性颈部创伤的处理很有用。与外科手术相比，经导管动脉栓塞术治疗椎动脉损伤是安全的，且易于控制出血。
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