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报道225例面颅伤的救治,伤因:车祸,打击伤占66.6％,火器伤占12.4％,伤情均较复杂。颌面软组织开放伤行早期彻底清创,重视分层对合缝合,避免瘢痕畸形;颌骨损伤:下颌骨骨折,闭合复位,颌间弹性牵引固定;上颌骨骨折复位,颌间结扎配合弹性吊颌帽。火器伤清创复位,固定;脑震荡重视伤情观察,对症处理;脑挫伤除伤情观察外予脱水治疗,合并颅内血肿者特别重视伤情变化,不失时机进行CT扫描复查;对症状恶化,血肿量增大者紧急开颅清除。治疗结果:痊愈224例,治愈率99.55％,留有轻度脑损伤后神经症和偏瘫的24例,癫痫20例,涎瘘1例。因颅内血肿死亡1例,疗效满意。
Reported 225 cases of craniocerebral injury treatment, causes: car accident, combat injury accounted for 66.6%, firearms accounted for 12.4%, injuries are more complicated. Maxillofacial soft tissue open wounds completely debridement early, pay attention to the stratification of suture, to avoid scar deformity; jaw injury: mandibular fracture, closed reduction, intermaxillary elastic traction fixation; maxillary fracture reduction, intermaxillary ligation with elastic hanging Jaw caps. In addition to observation of traumatic brain injury in addition to dehydration treatment, with intracranial hematoma who pay special attention to the injury changes, losing the opportunity for CT scan review; the symptoms of deterioration, Increased hematoma emergency craniotomy clearance. Treatment results: 224 cases were cured, the cure rate was 99.55%, there were 24 cases of neurosis and hemiplegia after mild brain injury, 20 cases of epilepsy and 1 case of salivary fistula. One patient died of intracranial hematoma, with satisfactory results.