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工业事故导致的严重270度环形穿透性颈部损伤的综合手术治疗:一例报告

Comprehensive surgical management of a severe 270-degree circumferential penetrating neck injury from an industrial accident: a case report.

作者信息

Jaber Jana, Al Jebawi Kholoud, Nasrallah Jamil, Al Shoufy Mira, Mehta Shubh, Hashim Hashim Talib, Al-Mukhtar Mahmoud Mussleh

机构信息

Department of Medicine, Faculty of Medical Sciences, Lebanese University, P. O. Box 6573/14 Badaro, Museum, Beirut, Lebanon.

Department of Life Sciences, Faculty of Sciences, Lebanese University, P. O. Box 6573/14 Badaro, Museum, Beirut, Lebanon.

出版信息

J Surg Case Rep. 2024 Dec 13;2024(12):rjae779. doi: 10.1093/jscr/rjae779. eCollection 2024 Dec.

Abstract

Penetrating neck injury (PNI), involving disruption of the platysma muscle, accounts for 10% of trauma cases and poses significant morbidity and mortality risks. This case report details the management of a 45-year-old male who sustained a 270-degree circumferential neck incision from an industrial accident. The patient presented with a deep neck laceration, severe blood loss, and hypovolemic shock. Pre-hospital care included intubation, oxygen supplementation, and fluid resuscitation. At the hospital, under general anesthesia, surgical interventions involved ligation of posterior neck vessels, hemostasis, muscle repair with Vicryl 1-0, drainage tube placement, and skin closure. Postoperative care included intensive monitoring, neurological assessments, and pain management. Effective management of severe PNI requires a multidisciplinary approach, combining prompt pre-hospital care, meticulous surgical techniques, and comprehensive postoperative management. Future research should focus on standardizing PNI management protocols and advancing surgical and diagnostic techniques to improve outcomes in similar critical cases.

摘要

穿透性颈部损伤(PNI)累及颈阔肌中断,占创伤病例的10%,并带来显著的发病和死亡风险。本病例报告详细介绍了一名45岁男性在工业事故中颈部有270度环形切口的治疗情况。患者出现颈部深部裂伤、严重失血和低血容量性休克。院前护理包括插管、补充氧气和液体复苏。在医院,在全身麻醉下,手术干预包括结扎颈部后方血管、止血、用1-0薇乔线修复肌肉、放置引流管和缝合皮肤。术后护理包括强化监测、神经评估和疼痛管理。严重PNI的有效管理需要多学科方法,结合及时的院前护理、细致的手术技术和全面的术后管理。未来的研究应专注于规范PNI管理方案,并推进手术和诊断技术,以改善类似危急病例的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f9e/11640811/a22fcacb3733/rjae779f1.jpg

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