36例颅颌面部火器伤的诊治

Diagnosis and treatment of firearm injuries in craniofacial region in 36 cases

目的 探讨颅颌面部火器伤后的早期诊断、治疗。方法 回顾性总结 1975年 1月～ 2 0 0 2年 6月收治的 36例颅颌面部火器伤病例的病历资料。本组病例入院时GCS 5～ 12分。闭合伤 3例 ,穿透伤 33例。结果 本组达到临床治愈标准 2 0例 ,好转 7例 ,自动出院 2例 ,死亡 7例。死因分别为原发伤过重、颅内感染、失血性休克。结论 对颅颌面部火器伤诊治应重视病史及生命体征变化 ,处理原则先急后缓 ,保守治疗应严格筛选。合并面神经损伤不宜早期缝合 ,延期微创手术是有效的方法。

Objective To explore early diagnosis and treatment of firearm injury in craniofacial region.?Methods The result of 36 cases of firearm injuries in craniofacial rgeion was summarized and studied retrospectively from 1975 to 2002 in our department. There were 29 male and 7 female patients,all cases were graded GCS 5～12. There were 3 cases of closed head injury and 33 cases of penetrated head injury.?Results In this series,20 cases were cured,7 cases gained improvement,7 cases died of severe primary injury,intracranial infection or shock.?Conclusion Important factors for diagnosis and treatment of craniofacial firearm injury include history of injury and change of life signs. Life threatening injuries were treatment first. Non surgical treatment is used only after strict consideration. Delayed micro surgery is recommended for facial nerve injury.