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患者周某,男,10岁,因汽枪子弹穿入颅底6小时,于1983年2月19日入院。检查:血压100/60mmHg,神志清楚,心肺(-),神经系统(-)。子弹由鼻旁右侧向后上方穿入、右鼻腔流血。X线正位片在右侧鼻腔中上方有0.5×0.3cm异物阴影。侧位片异物于鼻咽顶部,蝶窦下方,适在上颌后磨牙水平延长线后2cm,再垂直向上2cm。于左侧鼻腔气管插管强化分离麻醉下,软腭正中纵行切开,此时触摸鼻咽顶部及右侧鼻后孔均未发现异物,后用弯头血管钳伸入右侧鼻后孔0.5cm,于其顶那碰及金属异物,即以剥离器分离软组织,顺利取出异物。术后一周出院。
Patient Zhou, male, 10 years old, was admitted to hospital on February 19, 1983, for a six-hour run-in to the skull base. Check: blood pressure 100 / 60mmHg, conscious, cardiopulmonary (-), nervous system (-). The bullet penetrates from the right side of the nose to the back and the right nasal bleeding. X-ray film in the right side of the nasal cavity above 0.5 × 0.3cm foreign shadow. Lateral piece of foreign body in the top of the nasopharynx, sphenoid sinus, suitable for maxillary post-molar extension of the line after 2cm, and then vertically up 2cm. In the left nasal endotracheal intubation intensive anesthesia, the middle of the soft palate longitudinal incision, then touch the top of the nasopharynx and the right posterior orifice of the nose were not found foreign body, then elbow vascular forceps into the right posterior orifice 0.5 cm, at the top that touch and metal foreign body, that is, the separation of soft tissue with a stripper, the smooth removal of foreign bodies. One week after discharge.