Serious childhood injuries caused by air guns.

OBJECTIVE: To determine the severity of nonfatal injuries to children caused by air guns and pellet guns. DESIGN: Case series (hospital chart review). SETTING: Inpatient wards of the Children's Hospital of Eastern Ontario. PATIENTS: All children under 18 years of age admitted to the hospital from Jan. 1, 1979, to Dec. 31, 1989, under ICD code E917, E922, E955, E965, E970 or E985 who had suffered air gun injuries. MAIN OUTCOME MEASURES: Personal data, circumstances of event and clinical data. RESULTS: The 43 children (37 boys) had a median age of 12 years. The circumstances of the accident were known in 20 cases: 17 children were playing and 3 were cleaning the gun when it went off. Four children thought the gun was unloaded. In five cases the bullet ricocheted into the eye. Nine injuries were self-inflicted. Injury was to the extremities in 21 (49%), the eyes in 15 (35%) and the head and neck in 7 (16%). The median length of hospital stay was 4 days. Six children had long-term disabilities, all the result of eye injuries; two had cataract surgery, and four required enucleation of the eye. CONCLUSIONS: Air guns can cause serious injury to children. Their sale needs to be banned or at least carefully regulated.     

Ocular injuries caused by magpies.

This paper presents a series of six patients with ocular injuries resulting from magpie attacks. Five cases involved children. In two cases the penetration was overlooked initially. In one case the keratitis was caused by Bacillus cereus. Full ophthalmic examination, including indirect ophthalmoscopy and microbiological studies, must be undertaken initially to identify unrecognised eye injuries and to prevent the possible sight-threatening complications of vitreal fibrosis with subsequent retinal detachment or endophthalmitis.     

外伤后手功能障碍的系统康复治疗

目的　观察系统的康复治疗对外伤后手功能障碍的疗效。方法　利用多种物理因子 ,结合运动疗法 ,中药薰洗及心理疗法 ,对 3 0例手外伤后功能障碍 ,造成手日常生活能力下降者康复治疗。结果　经过系统康复治疗后 ,采用拇指运动功能评价 ;示、中、环、小指Boye方法评价和英国医学研讨会标准进行手部皮肤感觉障碍的评价 ,手功能障碍改善明显。结论　系统康复治疗的及时介入能较好地改善手外伤后功能障碍 ,提高日常生活能力。     

交通伤致重型浮膝损伤及其合并伤的救治

目的探讨交通伤致重型漂浮膝损伤及其合并伤的救治方法。方法（1）“120”院前转运。急诊救治，及早识别合并伤，伤后立即下肢固定制动或应用外固定架；（2）多学科协同会诊，及时处理严重危及生命的合并伤；（3）生命体征平稳，根据骨折分型，早期手术内固定，重建膝关节稳定。结果本组共67例，死亡8例，余59例行骨折固定术，随访12-36个月，达到或接近解剖复位44例，合并脑外伤致功能障碍2例，截肢3例。结论（1）“120”有效制动转运，在紧急悄况下使用外固定支架，早期全面综合评价伤情；（2）多学科协同会诊，对严重危及生命的合并伤及时治疗，降低了死亡率，为骨科手术做准备；（3）早期手术复位内固定，重建膝关节稳定，早期术后功能康复锻炼。     

Orbitofacial wounds and cerebral artery injuries caused by umbrella tips

Penetrating orbitofacial wounds inflicted by the sharp metal tips of umbrellas may go unrecognized. This type of injury is not generally appreciated as having fatal consequences. Immediate neurologic and radiologic evaluations are diagnostic. The value of computerized tomography and cerebral angiography is stressed.     

Multiple cardiovascular injuries and motor vehicle accidents.

A patient sustained blunt chest trauma in a motor vehicle accident. Cardiovascular trauma was initially obscured by more obvious orthopedic injuries. Thoracic aortic transection with false aneurysm formation was discovered incidentally during cardiac catheterization for traumatic tricuspid insufficiency. Successful repair of both lesions was subseqeuntly performed. This case demonstrates the difficulty in recognizing cardiovascular trauma in survivors of motor vehicle accidents and emphasizes the need for an aggressive diagnostic approach with consideration of coexisting injuries in patients who have sustained blunt chest trauma.     

老年人跌倒致重型颅脑损伤的危险因素分析

目的 了解本地区老年人跌倒致颅脑损伤流行病学情况,分析老年人跌倒并发重型颅脑损伤的危险因素。 方法 回顾性分析2013年1月1日-2014年12月31日南昌市青云谱区内跌倒、且经"120"送至南昌市区内各医院住院治疗的77例老年患者的临床资料,研究对象纳入标准:①年龄 ≥ 60岁;②有明确跌倒致头部外伤史;③初始CT扫描明确外伤性颅脑损伤。排除标准:①年龄<60岁;②不符合颅脑损伤诊断标准;③颅脑损伤非跌倒所致。对其相关单因素采用χ2检验,将有意义的单因素纳入Logistic回归模型进行分析,统计软件采用SPSS 17.0。 结果 单因素分析显示,老年人跌倒致重度颅脑损伤与性别、入院时间、跌倒平面、相关枕颞着地、心脑血管基础病有关(P<0.05),与年龄、合并伤无关(P>0.05)。进一步对相关因素Logistic回归分析显示,心脑血管基础病(OR=5.555)、相关枕颞部着地(OR=4.420)是老年人跌倒致重型颅脑损伤的高危因素。 结论 对有心脑血管基础病、相关枕颞着地的跌倒致颅脑伤老年患者应密切观察病情变化,把握时机,尽早进行积极干预,以控制危险因素,减少继发脑损伤,降低重型颅脑损伤的发生率,改善愈后。老年人跌倒的社区宣教应有颅脑损伤的相关知识,加强颅脑损伤知识的宣教,提高老年人对颅脑伤的认识,预防老年人跌倒致重型颅脑伤的发生是必要的。      

A clinical study of penetrating craniocerebral injuries caused by firearms

Ａｃｌｉｎｉｃａｌｓｔｕｄｙｏｆｐｅｎｅｔｒａｔｉｎｇｃｒａｎｉｏｃｅｒｅｂｒａｌｉｎｊｕｒｉｅｓｃａｕｓｅｄｂｙｆｉｒｅａｒｍｓ￥ＺｈａｎｇＸｉａｎｇ（章翔）；ＬｉｕＷｅｉｐｉｎｇ（刘卫平）；ＺｈａｎｇＪｉａｎｎｉｎｇ（张剑宁）；ＷａｎｇＬｉｇｅｎ...     

多发伤合并肺挫伤致急性呼吸窘迫综合症的治疗体会

目的 提高诊治肺挫伤致急性呼吸窘迫综合症(ARDS)的认识.方法 对18例肺挫伤致急性呼吸窘迫综合症患者的临床情况进行回顾性分析,采用SIMV+PSV+PEEP模式行机械通气.观察通气前后SpO2、血气分析、生命体征及临床症状的变化.结果 机械通气后PaO2、PaCO2、PaO2/FiO2及HR值较通气前明显改善,有统计学意义(P<0.01),SpO2高于通气前(P<0.05).本组治愈15例,死亡3例,发生肺部感染8例.结论 适当的PEEP应用机械通气是救治肺挫伤合并ARDS的有效的方法.     

管棒伤所致多发伤65例急诊救治

目的:观察棒伤所致多发伤患者的急诊救治方法,分析急诊救治方法在临床中的应用价值.方法:随机选取我院2017年11月-2018年11月我院接收的65例管棒伤所致多发伤的患者,根据患者选择的急诊救治方法不同,将患者归纳为观察组与对照组,观察组33例,对照组32例.对照组为一般急诊救治,观察组为针对性急诊救治.结果:2组急诊救治后并发症发生率的对比,差异显著(P<0.05).2组急诊救治效果的对比,差异显著(P<0.05).结论:对管棒伤所致多发骨伤实施针对性的急诊救治,能够有效控制急诊救治后并发症的发生率,提高患者的自理能力,价值较为显著,可在临床中推广应用.     

钼中毒大鼠心脏损伤的研究

用含有0.1％钼酸铵的常规饲料喂饲大白鼠,使之发生中毒并重点观察其对心脏的损伤作用。结果证明:钼中毒大鼠除可发生严重贫血、明显铜缺乏外,有显著的心肌肥大及轻度的心肌损伤。心肌肥大和贫血可能都与有效性铜缺乏有关。     

腹部损伤并出血性休克43例临床分析

目的：探讨腹部损伤并大出血的临床特点与手术治疗体会。方法：总结我院1999年1月至2002年12月间收治腹部损伤并发出血性休克43例的临床资料。结果：全组均行手术治疗。死亡3例，占7．0％(3／43)，胰腺假性囊肿、术后出血1例，切口感染2例。结论：出血性休克是腹部损伤死亡的主要因素，早期诊断与手术是治疗成功的关键。