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目的总结我们积累的远离穿透道的颈部血管损伤的经验。方法获得机构审查委员会的许可,在外伤登记处查阅5年内由于颅面部枪弹伤导致的颈部动脉损伤而行颈部血管CT成像的病例,并查阅病人影像及临床病例资料。结果 427例颅面部枪弹伤的病人,其中222例行CT血管成像,56例损伤病人共检查出78处血管损伤。5例颈内动脉损伤来自伤道的牵拉,这种颈动脉的间接损伤的发生率在病人中为1.2%,而在进行CT血管成像的病人中为2.8%。结论这种间接的来自颅面部枪弹伤的颈部动脉损伤的发生率略高于单纯钝挫伤。颅面部枪弹伤病人行CT血管成像检查可以意外发现远离穿透道的颈部血管牵拉伤。这些损伤的意义及最佳治疗方法还是未知的,确定颅面部枪弹伤中颈部动脉间接损伤的意义需要更多的经验。要点①颈部血管钝性损伤有几个未知的危险因素。②颈部血管损伤可发生于远离颅面部枪弹伤的部位。③颅面部枪弹伤是颈部血管损伤的一个危险因素。
OBJECTIVE: To summarize our experience with the accumulation of vascular lesions in the neck away from the penetrating tunnel. Methods Patients were reviewed by the Institutional Review Board for reviewing CT images of neck vessels at 5 years due to craniofacial bulla wounds caused by craniofacial bullet wound injuries and reviewing patient images and clinical case data. Results A total of 427 patients with craniofacial bullet wounds were included in this study. Totally 222 CT angiography were performed in 56 patients, and 78 vascular lesions were detected in 56 patients. Five cases of internal carotid artery injury were drawn from the injured trauma and the incidence of this indirect carotid injury was 1.2% of patients and 2.8% of patients undergoing CT angiography. Conclusion The incidence of neck artery injury indirectly from craniofacial shotgun is slightly higher than that of simple blunt trauma. Craniofacial bullet wound patients underwent CT angiography can accidentally find the neck vascular pull injury away from the penetrating tunnel. The significance of these injuries and the best treatment is still unknown, to determine the significance of indirect injury of the neck artery in craniofacial shotgun surgery needs more experience. Key Points ① There are several unknown risk factors for blunt cervical vascular injury. ② neck vascular injury can occur in the parts away from the craniofacial bullet wound. ③ craniofacial bullet wound is a risk factor for cervical vascular injury.