颅脑非军用枪弹伤的救治(附29例临床报告)

Management of civilian gunshot induced brain injuries in 29 cases

目的探讨枪弹致颅脑损伤的特点及救治原则。方法对我院近15年来收治的枪弹致颅脑损伤29例病人的临床资料、救治方法及预后进行回顾性分析。结果按伤后6个月的GOS预后评估:死亡3人,重残1人,中残7人,良好18人。结论对颅脑穿透伤病人,强调行头颅CT检查的必要性,必要时行DSA检查;不要求行彻底清创术,主张微创急诊清创术,异物摘除术的指征要严格把握。

Objective To investigate the clinical characteristics of the brain gunshot injury and its criteria of the therapeutic interventions. Methods The clinical features, therapeutic interventions, and prognoses of 29 civilian patients with gunshot injuries of the brain admitted in our hospital within the last 15 years were analyzed retrospectively. Results The outcome was assessed with GOS 6 months after the injury. Of the 29 patients, 3 died, 1 was severely disabled, 7 mildly disabled, and 18 recovered well. The result was better than that of in the literature. Conclusion Computed tomographic (CT) scanning is emphasized, and digital subtraction angiography (DSA) should be conducted if necessary. Minimally aggressive debridement is recommended. The indication for extraction of the retained foreign body should be cautiously considered.