颅脑火器伤的判断与救治

THE JUDGEMENT AND MANAGEMENT OF MISSILE HEAD INJURY

分析总结颅脑火器伤的临床特点。方法。对３１年内收治的２０１例颅脑火器伤病例进行分析。结果：男１７９例，妇女２例；盲管伤１１９例，贯通伤７０例，浅线伤７例，颅面联伤５例；早期合并症主要有：脑挫裂伤８８．６％，颅内血肿１９．４％，感染２１．０％。

Objective:To study the clinical characteristics of missile head injury.Method:201 cases who had suffered from missile head injury in 31 years were analysed.Results:There were 179 cases of male and 22 cases of female.Among these cases,119 were perforating wounds,70 were penerating wounds,7 were shallow tangent wounds and 5 were cranial-facial wounds.The main early mobidity was:brain contusion 88.6%;intracranial hematoma 19.4%;infection 21.0%.main late mobidity was foreign body retain and epilepsy.in this group,26 patients died after injury.The mortality was 12.9%.Conclusion:In missile head injury,the projectile have a strong pressure wave which can create a big temporary wound in the brain,the head injury are always severe and diffused.It should be avoid for a neurosurgeon to diagnose and manage a missile head injure case with the common head trauma mechanism and experiences.for decreasing the mortality and mobidity.it is very important to make a accurate judgement as early as possible,debridement completely,protect the brain tissue from secondary injury and any complication,pay more attention to the selection of approach and the principle in surgery.