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目的研究非战争时期医院收治的颅脑火器伤在临床诊断和治疗中的特点。方法对86例平时收治的各类颅脑火器伤者进行回顾性分析,探讨其诊断和治疗等方面的特点,寻找最佳的诊治方案。结果除2例(2%)在手术后24h内死于大血管损伤和严重脑损伤外,其余患者均经手术治愈(80例,93%)或症状改善(4例,5%)。结论颅脑火器伤是引起人群死亡和致残的最为严重的原因。彻底清除异物,特别是彻底清除碎骨片和失活组织,把开放性损伤变为闭合性损伤极为重要。X线头颅摄片金属异物定位、立体定向技术、异物细菌培养和药敏试验、以及抗痫药的应用是降低平时颅脑火器伤死亡率和并发症的关键。
Objective To study the characteristics of craniocerebral firearm wounds admitted to hospitals during non-war period in clinical diagnosis and treatment. Methods A retrospective analysis of 86 cases of all kinds of craniocerebral injuries treated in peacetime was carried out to discuss the characteristics of diagnosis and treatment and to find the best diagnosis and treatment plan. Results Two patients (2%) died of macrovascular injury and severe brain injury within 24 hours after operation. The remaining patients were cured by surgery (80 cases, 93%) or improved symptoms (4 cases, 5%). Conclusion The craniocerebral firearm injury is the most serious cause of death and disability in the population. Thoroughly remove the foreign body, especially the complete removal of bone fragments and inactivation of tissue, it is very important to turn open lesions into closed lesions. X-ray skull metal foreign body positioning, stereotactic technology, foreign body bacterial culture and drug susceptibility tests, and the application of anti-epileptic drugs to reduce the mortality and complications of craniocerebral injury is the key.