Ayuyao A M, Kaledzi Y L, Parsa M H, Freeman H P
Ann Surg. 1985 Nov;202(5):563-7. doi: 10.1097/00000658-198511000-00005.
We reviewed the records of 257 patients (ages, 16-83 years) with penetrating neck wounds (119 gunshot and 138 stab) managed at Harlem Hospital Center. Among the first 148 patients, 134 were managed by mandatory neck exploration; 42 had injuries (31%), and 92 (69%) had no injury. There were four deaths (3%) and seven (5%) morbidities. Because of the high rate of unnecessary operations, the following 109 patients were managed selectively, 40 by exploration, and nine of the 40 (22%) had no injury; 69 were observed and did not require subsequent operative intervention. There were six deaths (5.5%) and six morbidities (5.5%) among the second group. Morbidity and mortality were unrelated to the method of management but related to the type and severity of injuries, associated injuries, preexisting illnesses, and age of the patients. The frequency of operations for penetrating neck wounds without structural injuries was minimized in the selective exploration group.
我们回顾了哈莱姆医院中心收治的257例颈部穿透伤患者（年龄16 - 83岁）的记录，其中枪伤119例，刺伤138例。在前148例患者中，134例行强制性颈部探查；42例（31%）有损伤，92例（69%）无损伤。有4例死亡（3%），7例（5%）出现并发症。由于不必要手术率较高，后109例患者进行了选择性处理，40例行探查，其中9例（22%）无损伤；69例进行观察，无需后续手术干预。第二组中有6例死亡（5.5%），6例出现并发症（5.5%）。并发症和死亡率与处理方法无关，而与损伤类型和严重程度、合并伤、基础疾病以及患者年龄有关。在选择性探查组中，无结构损伤的颈部穿透伤手术频率降至最低。
