Treatment on Carotid Artery Trauma_West China Medical Journal

Authors：

ZHONG Fenglin ¹ , ZHAO Chenyang ¹ , LAN Yuping ¹ , FU Li ²

1. Department of Orthopaedics; 2. Department of Cardio-Thoracic Surgery; Central Hospital of Panzhihua City, Panzhihua, Sichuan 617067, P. R. China;

Corresponding?author：

Keywords：

頸總動脈; 鎖骨下動脈; 椎動脈; 損傷; 搶救

Video：

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目的　總結頸動脈損傷患者救治的臨床經驗。方法　2003年1月－2006年6月，搶救5例頸動脈損傷患者。男3例，女2例；年齡21～35歲。其中左右頸總動脈各1例，左鎖骨下動脈2例，左椎動脈1例。合并損傷：左頸內靜脈貫通傷1例，左胸導管及交感神經損傷1例，食道損傷1例，左鎖骨骨折1例。受傷至入院時間20 min～3個月。受傷原因：刀刺傷3例，誤食縫衣針伴感染1例，車禍傷1例。采用血管吻合修復頸總動脈及椎動脈3根、側壁修補修復左鎖骨下動脈1根、左頸內靜脈1根及自體血管移植術修復左鎖骨下動脈1根。術中輸血量1 000～11 000 mL,平均3 800 mL。結果　所有患者均搶救成功，傷口Ⅰ期愈合，經1～3年隨訪，無神經功能障礙。結論　頸動脈損傷救治成功的關鍵在于盡早做出診斷，快速有效的急救及選擇正確的治療方法。

Citation： ZHONG Fenglin,ZHAO Chenyang,LAN Yuping,FU Li. Treatment on Carotid Artery Trauma. West China Medical Journal, 2012, 27(12): 1852-1854. doi: Copy

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2.	左可軍, 徐睿, 賴銀妍, 等. 經鼻內鏡手術頸內動脈損傷的緊急處理與接續治療[J]. 中華耳鼻咽喉頭頸外科雜志, 2012, 47(7): 554-558.
3.	Papanagiotou P, Roth C, Walter S, Haass A, et al. Angiographic evidence of reperfusion injury after carotid artery stenting[J]. J Am Coll Cardiol, 2012, 60(5): 7.
4.	Malan J, Lefeuvre D, Mngomezulu V, et al. Angioarchitecture and treatment modalities in posttraumatic carotid cavernous fistulae[J]. Interv Neuroradiol, 2012, 18(2): 178-186.
5.	Kaouel K, Mechergui S, Ben Mrad I, et al. Surgical management of extracranial carotid artery aneurysm[J]. J Mal Vasc, 2012, 37(4): 201-206.
6.	Kumar A, Ahmed J, Reading N, et al. Life-threatening carotid haemorrhage following blunt trauma[J]. J Laryngol Otol, 2010, 124(9): 1030-1032.
7.	Nicosia A, Nikas DN, Castriota F, et al. Diagnosis and management of periprocedural complications of carotid artery stenting[J]. G Ital Cardiol (Rome) , 2009, 10(11-12): 718-724.
8.	Erkut B, Ate? A, Alper F, et al. Traumatic pseudoaneurysm of the right common carotid artery due to injury below the left clavicle[J]. Turk Kardiyol Dern Ars, 2010, 38(1): 70.
9.	Gladstone G, Rina PM, Renato PS, et al. Evaluation of the criteria for angiotomography indications in the diagnosis of carotid and vertebral arterial injury associated with blunt trauma[J]. World J Emerg Surg, 2010, 26(5): 17.
10.	Rivet C, Schoen V, Michel X, et al. Traumatic carotid-artery dissection[J]. Rev Prat, 2010, 60(2):170.
11.	Rajz G, Simon D, Bakon M, et al. Traumatic carotid artery dissection[J]. Isr Med Assoc J, 2009, 11(8): 507-508.
12.	郭起, 劉宏鵬, 王俊蓮, 等.頸總動脈損傷搶救6例報告[J].口腔頜面外科雜志, 2006, 16(1): 62-63.
13.	Ohba S, Kuroshima Y, Mayanagi K, et al. Traumatic aneurysm of the supraclinoid internal carotid artery-case report[J]. Neurol Med Chir (Tokyo), 2009, 49(12): 587-589.
14.	朱曉峰, 戰鵬, 徐世慶.鎖骨下動脈搶救3例[J].中國心血管病研究雜志, 2004, 2(3): 212.
15.	陳宇軒, 韓小憲, 張慶詩. 椎動脈損傷的診斷與治療[J].現代口腔醫學雜志, 2004, 18(6): 523-525.
16.	Tsai YH, Wong HF, Weng HH, et al. Stent-graft treatment of traumatic carotid artery dissecting pseudoaneurysm[J]. Neuroradiology, 2010, 52(11): 1011-1016.
17.	Antoniv VF, Antoniv TV, Pronchenko SV, et al. A foreign body in the neck with injured larynx and common carotid artery[J]. Vestn Otorinolaringol, 2009 (5): 63-64.

1. 　段志泉, 張強. 實用血管外科學[M]. 沈陽: 遼寧科學技術出版社, 1999: 221-224.
2. 　左可軍, 徐睿, 賴銀妍, 等. 經鼻內鏡手術頸內動脈損傷的緊急處理與接續治療[J]. 中華耳鼻咽喉頭頸外科雜志, 2012, 47(7): 554-558.
3. 　Papanagiotou P, Roth C, Walter S, Haass A, et al. Angiographic evidence of reperfusion injury after carotid artery stenting[J]. J Am Coll Cardiol, 2012, 60(5): 7.
4. 　Malan J, Lefeuvre D, Mngomezulu V, et al. Angioarchitecture and treatment modalities in posttraumatic carotid cavernous fistulae[J]. Interv Neuroradiol, 2012, 18(2): 178-186.
5. 　Kaouel K, Mechergui S, Ben Mrad I, et al. Surgical management of extracranial carotid artery aneurysm[J]. J Mal Vasc, 2012, 37(4): 201-206.
6. 　Kumar A, Ahmed J, Reading N, et al. Life-threatening carotid haemorrhage following blunt trauma[J]. J Laryngol Otol, 2010, 124(9): 1030-1032.
7. 　Nicosia A, Nikas DN, Castriota F, et al. Diagnosis and management of periprocedural complications of carotid artery stenting[J]. G Ital Cardiol (Rome) , 2009, 10(11-12): 718-724.
8. 　Erkut B, Ate? A, Alper F, et al. Traumatic pseudoaneurysm of the right common carotid artery due to injury below the left clavicle[J]. Turk Kardiyol Dern Ars, 2010, 38(1): 70.
9. 　Gladstone G, Rina PM, Renato PS, et al. Evaluation of the criteria for angiotomography indications in the diagnosis of carotid and vertebral arterial injury associated with blunt trauma[J]. World J Emerg Surg, 2010, 26(5): 17.
10. 　Rivet C, Schoen V, Michel X, et al. Traumatic carotid-artery dissection[J]. Rev Prat, 2010, 60(2):170.
11. 　Rajz G, Simon D, Bakon M, et al. Traumatic carotid artery dissection[J]. Isr Med Assoc J, 2009, 11(8): 507-508.
12. 　郭起, 劉宏鵬, 王俊蓮, 等.頸總動脈損傷搶救6例報告[J].口腔頜面外科雜志, 2006, 16(1): 62-63.
13. 　Ohba S, Kuroshima Y, Mayanagi K, et al. Traumatic aneurysm of the supraclinoid internal carotid artery-case report[J]. Neurol Med Chir (Tokyo), 2009, 49(12): 587-589.
14. 　朱曉峰, 戰鵬, 徐世慶.鎖骨下動脈搶救3例[J].中國心血管病研究雜志, 2004, 2(3): 212.
15. 　陳宇軒, 韓小憲, 張慶詩. 椎動脈損傷的診斷與治療[J].現代口腔醫學雜志, 2004, 18(6): 523-525.
16. 　Tsai YH, Wong HF, Weng HH, et al. Stent-graft treatment of traumatic carotid artery dissecting pseudoaneurysm[J]. Neuroradiology, 2010, 52(11): 1011-1016.
17. 　Antoniv VF, Antoniv TV, Pronchenko SV, et al. A foreign body in the neck with injured larynx and common carotid artery[J]. Vestn Otorinolaringol, 2009 (5): 63-64.

West China Medical Journal

Treatment on Carotid Artery Trauma

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