颅脑穿透伤的诊治分析(附5例报道并文献复习)

Report of 5 case of penetrating brain injury and review of literature

目的总结颅脑穿透伤的诊治经验。方法回顾性分析2016年1月以来成功救治的5例颅脑穿透伤的临床资料,并结合文献进行分析。结果5例均获得良好预后,ADL评分95分以上,未出现颅内感染、出血、癫痫等并发症。结论正确认识异物及其进入颅内的途径,巧妙地设计手术入路,利用非功能区彻底地清创,运用颅底重建技术,联合、足量应用抗生素预防感染是成功救治颅脑穿透伤的关键。

Objective To summarize the experience in treating penetrating brain injury(PBJ).Method A retrospective analysis of 5 patients with PBJ treated in our hospital and review of the literature related to PBJ were performed.Results All the patients were recovered well without complications such as intracranial infection,hemorrhage and epilepsy.Activities of daily living scores were over 95 points in all the patients.Conclusions The characteristics of the penetrating object and the way through which it penetrated the brain should be well understood.The surgical approaches should be subtly designed before the operation,and injured brain tissues or foreign objects should be thoroughly evacuated through the non-functional area.The skull base reconstruction and preventative use of antibiotics in the peri-operative period also is very important for the rehabilitation of PBJ patients.