Metzdorff M T, Lowe D K
Am J Surg. 1984 May;147(5):646-9. doi: 10.1016/0002-9610(84)90132-6.
A review of 83 patients with penetrating neck wounds was performed to assess the relative merits of operation versus observation. Fifty patients (60 percent) underwent immediate surgery, 28 of whom (56 percent) had no significant neck injury. There were no deaths and only two complications (4 percent). Thirty-three patients (40 percent) were treated with initial observation, one of whom required subsequent surgery. In the latter group, there were also no deaths and two complications (6 percent). Length of hospital stay did not differ between patients with negative findings on exploration and those observed. When clinical signs as indications for surgery were present, management was more often correct than when signs were absent (82 and 52 percent, respectively), but the presence or absence of signs correctly predicted injury or lack of injury in over 80 percent of the patients. These data demonstrate the safety and efficacy of selective observation of patients with penetrating neck trauma, and confirm that clinical signs are a reliable indicator of significant injury.
对83例颈部穿透伤患者进行了回顾性研究，以评估手术与观察的相对优缺点。50例患者（60%）接受了即刻手术，其中28例（56%）无明显颈部损伤。无死亡病例，仅有2例并发症（4%）。33例患者（40%）接受了初始观察，其中1例随后需要手术。在后一组中，也无死亡病例，有2例并发症（6%）。探查结果为阴性的患者与接受观察的患者住院时间无差异。当存在作为手术指征的临床体征时，处理正确的比例高于无体征时（分别为82%和52%），但体征的有无在超过80%的患者中正确预测了损伤或无损伤情况。这些数据证明了对颈部穿透伤患者进行选择性观察的安全性和有效性，并证实临床体征是严重损伤的可靠指标。
