From the Division of Trauma and Acute Care Surgery, Department of Surgery (A.S., K.I.), Los Angeles General Medical Center; and Keck School of Medicine (A.S., K.I.), University of Southern California, Los Angeles, California.
J Trauma Acute Care Surg. 2024 Aug 1;97(2):175-182. doi: 10.1097/TA.0000000000004292. Epub 2024 Mar 25.
Diagnostic evaluation of penetrating neck trauma has evolved considerably over the last several decades. The contemporary approach to these injuries is based primarily on clinical signs of injury and multidetector computed tomographic angiography. The neck is evaluated as a unit, rather than relying on the surface anatomy zones in which external injuries are seen to guide the workup of internal injuries. This "no-zone" approach safely spares many patients from negative explorations and unnecessary invasive tests. The purpose of this review is to describe an evidence-based approach to the diagnostic evaluation of penetrating neck trauma, including indications for adjunctive testing beyond physical examination and multidetector computed tomographic angiography.
Literature Synthesis and Expert Opinion; Level V.
在过去几十年中,穿透性颈部创伤的诊断评估发生了很大的变化。目前,这些损伤主要基于临床损伤迹象和多排螺旋 CT 血管造影。颈部作为一个整体进行评估,而不是依赖于外部损伤所在的表面解剖区域来指导内部损伤的检查。这种“无区域”方法可以安全地避免许多患者进行阴性探查和不必要的有创检查。本文的目的是描述一种基于证据的穿透性颈部创伤诊断评估方法,包括体格检查和多排螺旋 CT 血管造影之外的辅助检查的适应证。
文献综合和专家意见;等级 V。