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最近,我科收治1例铁镐意外经鼻刺入颅底造成铁镐异物并贯通伤患者,报道如下.患者,男,20岁.于1995年11月1日凌晨在矿井中挖煤时,被一块从头左上方落下、重约250kg的巨石击中右肩肿骨处,跌倒时鼻部被立于地上的一铁镐刺中.当时少量出血,自觉疼痛剧烈,未昏迷,无呕吐,异物未取出而急诊入院.初步诊断为:鼻颅底巨大金属异物并贯通伤.检查:T 36.5℃,P 80次/min,R 20次/min,BP18/13 kPa,神志清楚,四肢活动良好.铁镐中间柄环直径约5cm,两端镐臂各长约20cm,近柄环端宽3cm,厚1cm.一端镐尖完全自左鼻孔及鼻小柱刺入达20cm处固定,左鼻翼裂伤达1.5cm.头颅X线侧位片(异物取出后行头颅CT扫描)示:异物自鼻部刺入,穿通鼻中隔,中隔前部软骨向左上移位,后
Recently, we received a case of iron pick accidentally piercing the skull base through the nose caused by iron picks foreign body and through injuries, the patient reported, male, 20. In the early morning of November 1, 1995 coal mining in the mine, Was a piece falling from the top left, weighing about 250kg boulder hit the right shoulder swollen at the fall nose was stabbed in the ground a pickaxe was a small amount of bleeding, conscious pain, unconscious, no vomiting, foreign body Undetected and emergency admissions .According to the initial diagnosis: huge nasal skull metal foreign body and through the injury.Check: T 36.5 ℃, P 80 beats / min, R 20 beats / min, BP18 / 13 kPa, conscious mind, limbs well. Iron picks middle handle ring diameter of about 5cm, both ends of the pick arm length of about 20cm, near the handle ring end width 3cm, thickness 1cm. One end pick tip entirely from the left nostril and columella penetrating up to 20cm at fixed left alar laceration Up to 1.5cm .Craniotrope X-ray (foreign body line after the head CT scan): foreign body from the nose piercing, through the nasal septum, anterior septal cartilage shift to the left, after