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外伤、炎症感染、肿瘤侵犯均可引起颈总、颈内、外动脉及颈内静脉大出血,抢救不及时即发生休克及死亡。报告4例出血病例。例1:女,23岁。右下磨牙区血管瘤患者,因面部受击后口内瘤体破裂出血,当地医院止血抢救,5天后肿瘤糜烂,迅速增大并不断渗血而转入院,在全麻下施行颈外动脉结术及扎口内肿瘤切除,术中见颈外动脉表面有1×2cm紫色淋巴结2个,摘除1个后在甲状腺上及舌动脉间结扎颈外动脉,淋巴结病检报告为急性化脓性炎症。术后口内切口Ⅰ期愈合,颈部切口5天后感染,置橡皮片引流,脓液少量,术后第7天突然自引流口涌出鲜血约200ml,立即局部加压止血入手术室,打开原切口,见结扎线下方颈外动脉破裂,立即在其上下结扎,拆除原结扎线,冲洗清创后缝合,术后Ⅰ期愈合。例2:男,48岁。晚期颊粘膜癌皮肤破溃,颈淋巴结固定,入院施行颊颌颈联合根治术,额瓣及胸大肌瓣瓦合修复,术后48h负压引流量少而拔除,术后第5天颈部积液感染,拆线2针引流,第2天突然自引
Trauma, inflammatory infections, tumor invasion can cause neck total, internal and external carotid artery and internal jugular vein bleeding, the rescue is not timely that shock and death occurred. Report 4 cases of bleeding. Example 1: Female, 23 years old. Lower right molar area of hemangioma patients, due to facial rupture of oral tumor rupture, the local hospital to stop bleeding, 5 days after tumor erosion, rapid increase and continued bleeding and transferred to the hospital, under general anesthesia for external carotid artery node surgery And the tumor resection in the mouth, intraoperative see the external carotid artery surface 1 × 2cm purple lymph nodes 2, removed after a 1 in the thyroid and tongue arteries ligation of the external carotid artery, lymph node disease reported as acute suppurative inflammation. Postoperative incision incision healed, neck incision infection after 5 days, set the rubber drainage, a small amount of pus, the first 7 days after the sudden drainage of blood from the mouth about 200ml, immediately local pressure to stop bleeding into the operating room, open the original Incision, see the ligament below the external carotid artery rupture immediately ligation up and down, remove the original ligature, rinse debridement after suturing, postoperative Ⅰ heal. Example 2: Male, 48 years old. Late buccal mucosal cancer skin ulceration, cervical lymph node fixation, admission and implementation of buccal and cervical combined radical mastectomy, flap and pectoralis major flap flap repair, after 48h suction drainage and less removal of the first 5 days after neck Fluid infection, stitches 2-needle drainage, the first 2 days suddenly lead