Loss Lindsey, Henry Reynold, White Anna, Matsushima Kazuhide, Barrett Christopher, Lammers Daniel, Schreiber Martin, Inaba Kenji
Division of Trauma, Critical Care & Acute Care Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Division of Acute Care Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Trauma Surg Acute Care Open. 2025 Mar 24;10(1):e001619. doi: 10.1136/tsaco-2024-001619. eCollection 2025.
Although the overall incidence is low, penetrating neck trauma can result in devastating injuries. The traditional zonal approach is being increasingly abandoned in favor of selective approaches, especially as mandatory exploration can result in non-therapeutic interventions and associated complications. Additionally, the trajectory of the missile cannot be accurately assessed based on external wounds. Decision-making using the hard and soft signs of trauma and increased resolution of imaging modalities are progressively supplanting the older zonal approaches. Here we discuss the modern diagnostic approach, operative interventions, and the appropriateness of observation.
尽管总体发病率较低，但颈部穿透伤可导致严重损伤。传统的分区方法越来越被摒弃，转而采用选择性方法，尤其是因为强制性探查可能导致非治疗性干预及相关并发症。此外，无法根据外部伤口准确评估导弹的轨迹。利用创伤的硬指标和软指标以及提高成像模态分辨率进行决策，正逐渐取代旧的分区方法。在此，我们讨论现代诊断方法、手术干预及观察的适宜性。
