火器性颅脑损伤的飞射物常停留在脑的深部,由于弹道瞬间引出膨胀性空间对脑组织造成严重的压力波,故伤情多较重,常规清创手术往往不彻底,致残率高。近两年来,我院采用立体显微手术,对3例不同时期的火器伤一次性彻底清创,疗效满意,现报告如下。病例报告例1 男性,18岁,因被土枪击伤昏迷40小时于96年2月4日转入我院。体检:浅昏迷、右额见一约1.0cm 不规则的弹道入射口,右上下肢体瘫痪,肌力0级,双侧 Babinski 征(+),CT 扫描示右额颞局限性颅骨粉碎骨折。弹道横贯双额部,其中为血凝块及异物,弹片撞击对侧内板后向后折射停留在左基底节区。手术分两步进行,先取入射口及对侧内 Firearms craniocerebral injury often remain in the brain of the missile, due to the trajectory of the expansive space leads to brain tissue caused by a serious pressure wave, so more serious injuries, conventional debridement is often not complete, the rate of disability high. The past two years, our hospital using three-dimensional microsurgery, three cases of firearms at different times completely debridement, the curative effect is satisfactory, are as follows. Case Report 1 male, 18 years old, was killed by a gun wound coma for 40 hours on February 4, 1996 into our hospital. Physical examination: shallow coma, see the right amount of about 1.0cm irregular ballistic entrance, paralysis of the upper right and lower limbs, muscle strength 0, bilateral Babinski sign (+), CT scan showed the right frontotemporal localized skull fracture. Ballistic traversal of double forehead, which is a clot and foreign body, the shrapnel hit the contralateral inner plate refracted to stay in the left basal ganglia. Surgery in two steps, first taken into the mouth and contralateral