颅脑火器伤的临床特征与救治

目的 总结和分析颅服火器伤的临床特征与救治经验，提高其诊治水平。方法 回顾性分析了259例颅脑火器伤患者的损伤特点和救治情况。结果 本组火器伤类型为：盲管伤162例（62．5％）；贯通伤（32．8％）；切线伤12（4．6％）；合并其他部位伤63例（24．3％），损伤特点是：伤情急、创伤重、病情变化快。经急救和手术处理后，生存225例（86．9％），死亡34例（13．1％）。对187例平均随访5．6年；恢复良好105例（56．1％）；轻残54例（28．9％）；重残23例（12．3％）；植物生存状态5例（2．7％）。结论 迅速对患者开展现场急救、正确地进行伤情评估和急诊手术处理，是提高救治水平的关键。

Clinical features and treatment measures of craniocerebral firearm wounds

Objective To summarize and analyze the clinical features and treatment rules for craniocerebral firearm wounds in order to improve the diagnosis and treatment level. Methods The injury characteristics and treatment methods of 259 patients with firearm wounds were analyzed retrospectively. Results The craniocerebral firearm wounds were combined with blindgut wounds on 162 cases (62.5%), with penetrating wounds on 85 cases (32.8%), with tangential wounds on 12 cases (4.6%) and with other regions' wounds on 63 cases (24.3%). The characteristics showed that the traumatic condition was acute, severe and changed rapidly. After emergency treatment and operation, 225 cases (86.9%) survived and 34 cases died (13.1%). Long term follow-up studies (median 5.6 years) indicated that 105 cases (56.1%) had a good recovery. Mild disability, severe disability and vegetative state in this series were 28.9%, 12.3% and 2.7%, respectively. Conclusions It is very important to develop a rapid first-aid, evaluate the injury condition correctly and make proper operative treatments, which are very helpful for the doctors to improve their cure standards.