重型颅脑火器爆炸伤早期空运医疗后送一例并文献复习

A case of early aeromedical evacuation of severe craniocerebral firearm explosion injury and literature review

目的探讨重型颅脑火器爆炸伤早期空运医疗后送的可行性。方法报道1例重型颅脑火器爆炸伤术后患者的早期空运医疗后送全流程处置并文献复习。结果本例患者为男性, 20岁, 训练中意外被爆炸手榴弹弹片击中额部, 造成重型颅脑损伤, 急诊行清创及去骨瓣减压术。术后12 h由固定翼飞机经1.5 h航时后送至空军军医大学唐都医院。伤后4个月复查头颅CT示, 去骨瓣减压术后脑室扩张、脑实质多发软化灶形成。结论重型颅脑火器爆炸伤经过空运医疗后送前充分评估及后送中专业的重症管理, 早期空运医疗后送是可行的。

Objective To discuss the feasibility of early aeromedical evacuation(AE)for the wounded with severe craniocerebral firearm explosion injury.Methods The whole procedure of an AE mission for a case of severe craniocerebral firearm explosion injury was reported,and relevant literatures were reviewed.Results The forehead of a 20-year-old male patient was accidentally hit by grenade shrapnel in training and he was diagnosed as severe traumatic brain injury(sTBI).Emergency debridement and decompression were performed.The patient was transported to Tangdu Hospital,Air Force Medical University by 1.5 h of AE flight 12 h after operation.CT scan showed ventricular dilation after decompression and multiple softening foci in brain parenchyma 4 months after the injury.Conclusions Early-stage AE for sTBI patient is feasible with careful and thorough preflight assessment and professionalized ongoing intensive care.