Walsh M S
Department of General Surgery, State Hospital, Windhoek, Namibia.
Injury. 1994 Aug;25(6):393-5. doi: 10.1016/0020-1383(94)90133-3.
The management of penetrating injuries of the anterior triangle of the neck is controversial and poses several problems. A policy of mandatory neck exploration of these injuries is followed in the Department of General Surgery at the State Hospital, Windhoek. A retrospective study of patients presenting to one of the four surgical firms at The State Hospital was performed to see if this policy was justified. Twenty-seven patients were reviewed of which 25 presented acutely and two presented late with severe complications. The clinical and operative findings and the mortality rate of 7 per cent were similar to previous reports. The negative exploration of 30 per cent was less than previous reports of mandatory neck exploration for penetrating trauma. This may have been because exploration was limited to injuries involving the anterior triangle of the neck in this series. All 14 patients with positive clinical findings were found to have injuries at exploration and five of 13 patients (38 per cent) with no clinical signs were found to have injuries. Given these results and in the setting of The State Hospital it was felt that the policy of mandatory exploration was justified.
颈部前三角区穿透伤的处理存在争议，且带来了若干问题。温得和克国立医院普通外科对这些损伤采取了强制颈部探查的策略。对国立医院四家外科科室之一收治的患者进行了一项回顾性研究，以确定该策略是否合理。共审查了27例患者，其中25例为急性就诊，2例为晚期就诊且伴有严重并发症。临床及手术结果以及7%的死亡率与既往报告相似。30%的阴性探查率低于既往关于穿透伤强制颈部探查的报告。这可能是因为在本系列研究中，探查仅限于涉及颈部前三角区的损伤。所有14例有阳性临床发现的患者在探查时均发现有损伤，13例无临床体征的患者中有5例（38%）被发现有损伤。鉴于这些结果以及国立医院的实际情况，认为强制探查策略是合理的。
