Demetriades D, Charalambides D, Lakhoo M
Department of Surgery, Baragwanath Hospital, Johannesburg, South Africa.
Br J Surg. 1993 Dec;80(12):1534-6. doi: 10.1002/bjs.1800801213.
This prospective study of 335 patients with penetrating injuries of the neck examined the decision whether to operate or observe according to a protocol based mainly on physical examination. Emergency angiography was performed in only three patients. Sixty-six patients (20 per cent) were subjected to emergency operation because of signs and symptoms suggestive of significant injury (60 patients) or because of positive investigations (six). The remaining 269 patients (80 per cent) were selected for non-operative management. Two of these patients (0.7 per cent) required elective operation during the initial hospital stay. No deaths occurred in patients treated conservatively. Some 192 (72 per cent) of observed patients were available for early follow-up and 111 (42 per cent) for late follow-up. No significant complications were found. Physical examination is a reliable method for detecting significant injuries following penetrating neck trauma. Emergency angiography is rarely necessary.
这项针对335例颈部穿透伤患者的前瞻性研究，根据一项主要基于体格检查的方案，对手术或观察的决策进行了研究。仅3例患者进行了急诊血管造影。66例患者（20%）因提示严重损伤的体征和症状（60例）或检查结果阳性（6例）而接受急诊手术。其余269例患者（80%）被选择进行非手术治疗。其中2例患者（0.7%）在初次住院期间需要择期手术。保守治疗的患者无死亡病例。约192例（72%）观察患者可进行早期随访，111例（42%）可进行晚期随访。未发现明显并发症。体格检查是检测颈部穿透伤后严重损伤的可靠方法。急诊血管造影很少有必要。
