neck strangulation
Introduction
Introduction to neck injury Wrap the rope around the neck, by hand or other mechanical force, so that the object is tightened in the neck, causing damage to the soft tissue of the neck accompanied by severe hypoxia and even suffocation and death. This type of death is called strangulation or hang. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: fracture
Cause
Cause of neck injury
Cause of the disease (100%):
Often due to homicide, there are also people who commit suicide due to mental factors.
Pathogenesis
The death mechanism of strangling and sudden death is basically similar. Both of them rely on the rope to continuously compress the respiratory tract and blood vessels in the neck, causing serious cerebral circulation and respiratory function, causing serious hypoxia and suffocation in the body; or by stimulating the carotid sinus The vagus nerve reflex causes respiratory heartbeat sudden death and death. The difference is that the mechanical force of the two methods, the size and the action site are different. In recent years, it is believed that the venous compression may play an important role in the death of the injured.
Prevention
Neck injury prevention
There are no effective preventive measures for the disease, and early detection and early diagnosis is the key to the prevention and treatment of this disease.
Complication
Compression of neck injury Complications
Surviving casualties can be combined with amnesia or plant status (vegetative), and both thyroid cartilage and hyoid bone can be fractured.
Symptom
Symptoms of neck injury Common symptoms Dysphagia Skin abrasions Metabolic acidosis Forgetful purpura Difficulty breathing Dumbness Bleeding coma Heart arrest
Simple laceration, except for the local injury of the neck, there are skin abrasions, subcutaneous congestion, skin bruising, and the injury can be caused by the sulcus. There is no other special clinical manifestation, but the injury can often die due to lack of oxygen. , the injury usually has the following characteristics:
1. History of injury
If the injury does not lead to death, the wounded can provide a history of injury, mostly homicide, suicide is rare, according to the means and methods of the smashing can identify the two.
2. Neck groove
The sulcus is often located in the thyroid cartilage or below, and is rarely located above the thyroid cartilage, that is, it is lower than the dying position. The sulcus is generally horizontally ring-shaped and has a uniform depth. Its color is related to the texture of the rope, and the rough and hard rope is smashed. Often accompanied by epidermal exfoliation, subcutaneous hemorrhage, the color is brown or dark brown.
3. Facial signs
When Muller has jugular vein congestion, the pressure rises, the venule can rupture and hemorrhage, forming subconjunctival hemorrhage, but the strangled face of the strangled person is more purpura, swelling, and more with point bleeding, the eyeball is slightly outward, the tip of the tongue is exposed, etc. .
4. Sound hoarseness
The tissue edema on the laryngeal and glottis caused by Müller makes the casualty hoarse and even unable to pronounce. There may be a laryngeal sound when breathing, throat, tracheal bleeding, and edema may become obvious or aggravate after a period of time. Therefore, it is necessary to observe closely within 24 hours after the injury.
5. Dysphagia
The pain during swallowing is the most obvious symptom after Muller.
6. pulmonary edema or bronchial pneumonia
Müller to the dying wounded, after the release of Müller, most died of pulmonary edema, bronchial pneumonia or ARDS, which may be caused by aspiration or central nervous system damage.
7. Central nervous system damage
When Muller brain tissue is hypoxic, the wounded often have obvious central nervous system damage, even coma, the length of cerebral ischemia and hypoxia determines the prognosis, the short may completely return to normal; although the elderly are removed, but due to brain parenchyma Damage, cerebral edema is aggravated after cerebral blood flow is restored, and intracranial pressure rises, which in turn causes cerebral ischemia, forming a vicious circle. Surviving wounded may leave mental and neurological symptoms, from amnesia to vegetative state.
8. Fracture
The thyroid cartilage, the ring cartilage and the hyoid bone can all be fractured. The thyroid cartilage fracture is more common. If the neck violence is large, the cervical spine can be fractured, and the X-ray film of the neck can help diagnose.
9. Blood gas analysis
Patients with dyspnea or cardiac arrest may have respiratory acidosis and metabolic acidosis. Blood gas analysis should be performed. If the blood pH of the injured person is <2, the prognosis is very poor.
Examine
Neck injury check
Blood gas analysis: Patients with dyspnea or cardiac arrest may have respiratory acidosis and metabolic acidosis. Blood gas analysis should be performed. If the blood pH of the injured person is <2, the prognosis is very poor.
The thyroid cartilage, the ring cartilage and the hyoid bone can all be fractured. The thyroid cartilage fracture is more common. If the neck violence is large, the cervical spine can be fractured, and the X-ray film of the neck can help diagnose.
Diagnosis
Diagnosis and identification of neck injury
According to the medical history, clinical manifestations, laboratory tests and X-ray examination, it can be diagnosed.
