《美国创伤外科协会-世界急诊外科学会颈部血管损伤诊断与处理指南》解读OA

Cervical vascular injuries(CVIs),including blunt cerebrovascular injury(BCVI)and penetrating cervical vascular injury,are among the most challenging emergencies encountered in trauma surgery because of their distinct diagnostic and therapeutic characteristics.In 2026,the American Association for the Surgery of Trauma and the World Society of Emergency Surgery jointly published the first evidence-based guidelines for the diagnosis and management of CVIs.The guidelines comprehensively update current recommendations on screening,imaging evaluation,antithrombotic therapy,endovascular intervention,and management of penetrating cervical vascular injuries.Major advances include shifting the management of BCVI from symptom-driven diagnosis to proactive screening of high-risk patients,establishing antithrombotic therapy as the cornerstone of treatment while restricting endovascular intervention to selected indications,and replacing the traditional anatomical zone-based approach for penetrating injuries with a hemodynamic-and clinical sign-based"no-zone"strategy.This review systematically interprets the key recommendations and supporting evidence of the guidelines and discusses their applicability in the Chinese clinical setting in light of the high burden of cerebrovascular disease in China.It is expected to provide a useful reference for the standardized diagnosis and management of cervical vascular injuries in clinical practice.