Golueke P J, Goldstein A S, Sclafani S J, Mitchell W G, Shaftan G W
J Trauma. 1984 Dec;24(12):1010-4. doi: 10.1097/00005373-198412000-00002.
In an effort to settle the controversy regarding the optimal management of penetrating trauma to the neck, a randomized prospective study was conducted in which 160 patients with penetrating neck injuries admitted to Kings County Hospital between 1977 and 1982 were placed, by protocol, into two groups. Group A patients were explored routinely for all injuries to the neck violating the platysma muscle. Group B patients were managed selectively with operation based on clinical or radiographic evidence of major vascular, visceral, or airway injury. Data were collected retrospectively. Length of hospital stay, morbidity, and mortality were compared between groups A and B, as well as between patients explored or not, and no statistical difference was noted. Since there is no clear advantage to either routine or selective exploration in the management of penetrating neck wounds, we conclude that surgeons should base their treatment on their own experience, house staff and nursing support, and radiologic and operating room availability.
为了解决关于颈部穿透伤最佳处理方法的争议，我们进行了一项随机前瞻性研究。在1977年至1982年间，160例颈部穿透伤患者被收入国王郡医院，按照方案将他们分为两组。A组患者对于所有累及颈阔肌的颈部损伤均进行常规探查。B组患者则根据主要血管、内脏或气道损伤的临床或影像学证据进行选择性手术处理。数据进行回顾性收集。比较了A组和B组之间、进行探查和未进行探查的患者之间的住院时间、发病率和死亡率，未发现统计学差异。由于在颈部穿透伤的处理中，常规探查或选择性探查均无明显优势，我们得出结论，外科医生应根据自身经验、住院医师及护理支持情况以及放射科和手术室的可用情况来决定治疗方案。
