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复杂颈椎创伤的多学科治疗管理。

Multidisciplinary Therapeutic Management in Complex Cervical Trauma.

机构信息

Surgery Department, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.

Department of Anesthesia and Intensive Care, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2023 Mar 17;59(3):596. doi: 10.3390/medicina59030596.

DOI:10.3390/medicina59030596
PMID:36984596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10056657/
Abstract

: In the current literature, mandatory surgical exploration is a controversial topic, with some advocating for it and others against it, proposing a selective conservative management. This multidisciplinary therapeutic approach is based on clinical examination and serial paraclinical explorations associated with supportive drug treatment. : The study group consisted of 103 patients with complex cervical trauma pathology produced by various mechanisms such as car or domestic accidents, aggression, ballistic trauma, self-inflicted attempts, hanging or strangulation hospitalized in the Ear, Nose and Throat (E.N.T.) Clinic, at "St. Spiridon" Iași Hospital, between 2012 and 2016. : The universal clinical indication for urgent surgical exploration of the patient with complex cervical trauma is the presence of the following symptoms: unstable vital signs, significant pulsatile bleeding, hematoma with a substantial increase in size, shock, airway obstruction, open airway wound, hematemesis, or hemoptysis. In this context, we considered it worthwhile to research the management of complex cervical trauma in a reference university medical center, alongside the analysis of the patient's characteristics under different aspects (demographic, pathological aspects, therapeutic). : Complex cervical trauma has a variety of clinical aspects, with a variable evolution, which involves multidisciplinary therapeutic management. The increasing trauma rate is one of the main public health problems, requiring epidemiological studies, and the implementation of control strategies.

摘要

在当前的文献中,强制性的外科探查是一个有争议的话题,一些人支持,另一些人反对,主张选择性的保守治疗。这种多学科的治疗方法基于临床检查和一系列与支持性药物治疗相关的辅助检查。

该研究组包括 103 名因各种机制(如汽车或家庭事故、袭击、弹道创伤、自残、上吊或绞杀)导致复杂颈椎创伤病理的患者,这些患者在 2012 年至 2016 年间在雅西“圣斯皮里东”医院耳鼻喉科(E.N.T.)诊所住院。

对于复杂颈椎创伤患者,紧急外科探查的普遍临床指征是存在以下症状:生命体征不稳定、明显搏动性出血、血肿明显增大、休克、气道阻塞、开放气道伤口、呕血或咯血。在这种情况下,我们认为有必要在参考大学医学中心研究复杂颈椎创伤的治疗方法,并从不同方面(人口统计学、病理学方面、治疗)分析患者的特征。

复杂颈椎创伤有多种临床表现,演变情况不同,需要多学科的治疗管理。创伤发生率的增加是主要的公共卫生问题之一,需要进行流行病学研究和实施控制策略。

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Gunshot bullet embolus with pellet migration from the left brachiocephalic vein to the right ventricle: a case report.
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