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钝性颈部创伤后术中使用 Foley 球囊封堵控制颈内静脉撕裂伤

Internal Jugular Vein Avulsion Controlled With Intraoperative Foley Balloon Occlusion Following Blunt Neck Trauma.

作者信息

Melmer Patrick D, Simmonds Alexander, Aboutanos Michel

机构信息

Acute Care Surgery, Virginia Commonwealth University, Richmond, USA.

General Surgery, Virginia Commonwealth University, Richmond, USA.

出版信息

Cureus. 2024 Oct 6;16(10):e70925. doi: 10.7759/cureus.70925. eCollection 2024 Oct.

DOI:10.7759/cureus.70925
PMID:39502957
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11536751/
Abstract

Internal jugular vein injuries caused by blunt trauma are rare. Here, we describe the case of a severe internal jugular vein injury high in neck zone II and immediately lateral to the hypoglossal nerve, making surgical management extremely challenging. A Foley balloon inserted into the cranial end of the internal jugular vein allowed for effective hemorrhage control while the vein could be suture ligated. Balloon tamponade was helpful in a field with distorted and blood-stained anatomy. It allowed critical time to carefully dissect around the hypoglossal nerve and avoid the sequalae of its injury.

摘要

钝性创伤导致的颈内静脉损伤较为罕见。在此，我们描述一例发生在颈部II区高位、紧邻舌下神经外侧的严重颈内静脉损伤病例，这使得手术处理极具挑战性。将Foley球囊插入颈内静脉颅端可有效控制出血，同时可对静脉进行缝合结扎。在解剖结构扭曲且被血液污染的术野中，球囊填塞很有帮助。它为在舌下神经周围进行仔细解剖并避免其损伤后遗症赢得了关键时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/6acb227944ac/cureus-0016-00000070925-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/bc313f94cfe7/cureus-0016-00000070925-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/f21a8a079220/cureus-0016-00000070925-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/6acb227944ac/cureus-0016-00000070925-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/bc313f94cfe7/cureus-0016-00000070925-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/f21a8a079220/cureus-0016-00000070925-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfc/11536751/6acb227944ac/cureus-0016-00000070925-i03.jpg

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本文引用的文献

1
Improved mortality from penetrating neck and maxillofacial trauma using Foley catheter balloon tamponade in combat.在战斗中，使用 Foley 导尿管球囊填塞法可显著提高穿透性颈部和颌面创伤的死亡率。
J Trauma Acute Care Surg. 2013 Aug;75(2):220-4. doi: 10.1097/TA.0b013e3182930fd8.
2
Management of traumatic vascular injuries to the neck: a 7-year experience at a Level I trauma center.颈部创伤性血管损伤的管理：一级创伤中心的7年经验
Am Surg. 2012 Mar;78(3):335-8.
3
Blunt neck trauma: torn internal jugular vein after a motor vehicle crash.钝性颈部创伤：机动车碰撞后颈内静脉撕裂
J Emerg Nurs. 2008 Jun;34(3):249-50. doi: 10.1016/j.jen.2008.02.022.
4
Intrathoracic jugular vein avulsion after blunt chest trauma.钝性胸部创伤后胸内颈静脉撕脱伤
J Thorac Cardiovasc Surg. 2002 Jan;123(1):190-1. doi: 10.1067/mtc.2002.118037.