Cabasares H V
Am Surg. 1982 Jul;48(7):355-8.
The management of penetrating neck trauma continues to generate disagreement in the surgical literature. Current publications of the subject advocate selective surgical intervention only if facilities and manpower are adequate. This review of a 15-year experience in the setting of a community hospital shows unquestionably that if surgeons with clinical experience evaluate this type of trauma, more than 50 per cent of patients are spared necessary operations. On the other hand, if patients are selected to undergo surgery because of strong clinical indications and the decision is carried out promptly, unnecessary and costly diagnostic studies are avoided. By following this policy of selective surgical management, our mortality rate of 3 per cent compares favorably with reports in the literature. No increased morbidity was noted in those patients managed nonoperatively.
颈部穿透伤的处理在外科文献中仍存在争议。目前关于该主题的出版物主张，只有在设施和人力充足的情况下才进行选择性手术干预。对一家社区医院15年经验的回顾无疑表明，如果有临床经验的外科医生评估这类创伤，超过50%的患者可避免不必要的手术。另一方面，如果根据强烈的临床指征选择患者进行手术并迅速做出决定，可避免不必要且昂贵的诊断性检查。通过遵循这种选择性手术处理策略，我们3%的死亡率与文献报道相比具有优势。非手术治疗的患者未发现发病率增加。
