Jurkovich G J, Zingarelli W, Wallace J, Curreri P W
J Trauma. 1985 Sep;25(9):819-22.
The selective management of penetrating neck trauma implies an attempt to individualize care and minimize unnecessary surgical exploration. In asymptomatic patients, diagnostic studies are performed in an attempt to exclude clinically unrecognized injuries. This review of 100 consecutive cases of penetrating neck trauma assesses the role of ancillary diagnostic studies in 53 patients selectively managed. The diagnostic yield from a combination of angiography, fluoro-esophagography, and aerodigestive tract endoscopy was 22.6% (12 of 53). However, only five patients (9.4%) actually benefitted from ancillary diagnostic studies, in that angiography documented clinically unrecognized injury. In an effort to avoid the indiscriminate use of ancillary diagnostic studies, a selective management plan based on anatomic zones of injury is provided.
穿透性颈部创伤的选择性处理意味着尝试实现个体化治疗并尽量减少不必要的手术探查。对于无症状患者，进行诊断性检查以排除临床上未被识别的损伤。本项对100例连续性穿透性颈部创伤病例的回顾评估了辅助诊断性检查在53例接受选择性处理患者中的作用。血管造影、荧光食管造影和气消化道内镜检查联合应用的诊断阳性率为22.6%（53例中的12例）。然而，实际上只有5例患者（9.4%）从辅助诊断性检查中获益，因为血管造影证实了临床上未被识别的损伤。为避免盲目使用辅助诊断性检查，提供了一项基于损伤解剖区域的选择性处理方案。
