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[非典型头部枪伤的治疗方法——病例报告]

[Treatment methods of atypical gunshot wounds to the head--case reports].

作者信息

Mielniczek Paweł, Zieliński Grzegorz, Koziarski Andrzej

机构信息

Department of Neurosurgery, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine in Warsaw, Poland.

出版信息

Pol Merkur Lekarski. 2016 May;40(239):318-24.

Abstract

Due to a high mortality rate, headshot injuries pose serious diagnostic and clinical problems. In this work, we wanted to describe four atypical headshot injuries. The first patient with a headshot injury using a nail gun mishap; the second one after a headshot injury, as a result of attempted murder (the bullet came to a parasagittal halt in the left parietal area); the third victim, after a suicide attempt (the bullet was removed from clivus area, below the pituitary gland); in the case of the fourth patient, after shooting himself with a self-constructed weapon in the chin, the metal body was surgically removed - a bearing pellet from the corpus callosum. Males dominate among victims of headshot injuries. Alcohol is one of the elements that facilitate suicidal behaviour. Anti-spasm, antibacterial, anti-tetanus prophylaxes are incredibly important. In some cases, the metallic body does not have to be removed from the brain. Pulmonary embolism can be a cause of death after 7 days from injury.

摘要

由于死亡率高,头部枪伤带来了严重的诊断和临床问题。在这项工作中,我们想要描述四起非典型头部枪伤案例。第一例患者因钉枪意外造成头部枪伤;第二例是企图谋杀导致的头部枪伤(子弹在左顶叶矢状旁区域停滞);第三例受害者是自杀未遂(子弹从垂体下方的斜坡区域取出);第四例患者用自制武器射中下巴后,金属物体(胼胝体中的一颗轴承弹丸)通过手术被取出。头部枪伤受害者中男性占主导。酒精是助长自杀行为的因素之一。抗痉挛、抗菌、破伤风预防极其重要。在某些情况下,金属物体不必从大脑中取出。肺栓塞可能是受伤7天后的死亡原因。

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