Sofianos C, Degiannis E, Van den Aardweg M S, Levy R D, Naidu M, Saadia R
Department of Surgery, Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, Republic of South Africa.
Surgery. 1996 Nov;120(5):785-8. doi: 10.1016/s0039-6060(96)80084-5.
The management of penetrating neck trauma remains controversial, with many studies supporting either mandatory exploration or selective conservatism.
This is a prospective study of 75 patients with gunshot injuries to zone II of the neck. Forty patients (53.3%) underwent immediate exploration because of clinical indications or positive initial investigations. A 7.5% incidence of unnecessary explorations, a 5% mortality rate, and average hospital stay of 10.5 days were noted. Thirty-five patients with negative clinical or investigational findings underwent observation with constant monitoring. A 5.7% incidence of missed injuries, no mortality, and an average hospital stay of 3.5 days were noted for these patients.
We suggest that conservative management in gunshot injuries confined to zone II of the neck selectively supplemented by appropriate investigations is a viable proposition in this type of injury. Further contemporary studies reporting specifically on this injury will enable us to reach statistically significant conclusions.
穿透性颈部创伤的处理仍存在争议，许多研究支持强制性探查或选择性保守治疗。
这是一项对75例颈部II区枪伤患者的前瞻性研究。40例患者（53.3%）因临床指征或初始检查阳性而立即接受探查。发现不必要探查的发生率为7.5%，死亡率为5%，平均住院时间为10.5天。35例临床或检查结果为阴性的患者接受了持续监测下的观察。这些患者漏诊损伤的发生率为5.7%，无死亡病例，平均住院时间为3.5天。
我们认为，对于局限于颈部II区的枪伤，采用保守治疗并选择性地辅以适当检查，对于这类损伤是可行的方案。进一步专门针对此类损伤的当代研究将使我们能够得出具有统计学意义的结论。
