鞍区颅脑枪击伤的救治

发布时间：2018-05-05 10:04

本文选题：脑损伤 + 创伤　；参考：《中华创伤杂志》2002年05期

【摘要】：目的　探讨鞍区颅脑枪击伤急性期的救治及晚期鞍区金属异物摘除的方法。　方法　对 7例鞍区颅脑枪击伤患者行早期清创术 ,3例患者同时摘除金属异物 ;4例患者晚期采用显微手术摘除下丘脑、垂体内金属弹丸。所有患者均获随访 ,随访时间 3～ 11年。　结果　全部患者均康复 ,无下丘脑或垂体功能障碍。恢复良好 3例 ,轻残 3例 ,重残 1例。　结论　鞍区颅脑枪击伤患者 ,应早期行清创术 ,尽可能摘除金属异物 ,修补颅底脑膜防止脑脊液漏。术后加强抗感染、抗脑水肿治疗。重症患者需及时治疗继发性脑损害 ,积极治疗内分泌紊乱等并发症 ,在全身情况稳定后 ,采用显微手术摘除异物。显微手术对摘除脑深部重要部位的金属异物是一安全可靠的方法
[Abstract]:Objective to investigate the treatment of acute stage of Sellar region craniocerebral gunshot injury and the method of removing metal foreign body in the late stage of Sellar region. Methods 7 patients with craniocerebral gunshot injury in Sellar region were treated with early debridement and 4 patients with metal foreign body were removed by microsurgery. All patients were followed up for 3 to 11 years. Results all patients recovered without hypothalamus or pituitary dysfunction. The recovery was good in 3 cases, mild disability in 3 cases and severe disability in 1 case. Conclusion early debridement should be performed in patients with craniocerebral gunshot injury in the Sellar region. Metal foreign bodies should be removed as far as possible and meninges of skull base should be repaired to prevent cerebrospinal fluid leakage. The treatment of anti-infection and anti-cerebral edema was strengthened after operation. Severe patients need timely treatment of secondary brain damage, active treatment of endocrine disorders and other complications, after the stability of the whole body, microsurgery is used to remove foreign bodies. Microsurgery is a safe and reliable method for removing metal foreign bodies in the deep part of the brain.
【作者单位】：第一军医大学附属珠江医院神经外科第一军医大学附属珠江医院神经外科第一军医大学附属珠江医院神经外科第一军医大学附属珠江医院神经外科第一军医大学附属珠江医院神经外科
【分类号】：R826.5

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