Gizatullin Sh Kh, Stanishevskiy A V, Svistov D V
Burdenko Main Military Clinical Hospital, Moscow, Russia.
Kirov Military Medical Academy, St. Petersburg, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2021;85(5):124-131. doi: 10.17116/neiro202185051124.
There have been over 15 ended and ongoing armed conflicts in the world between 2014 and 2020. The total number of irrecoverable losses in these conflicts exceeded 800 000 people. In modern conflicts, gunshot head wounds account for 37.4% of sanitary losses of surgical profile. These injuries are characterized by high mortality rate. Changes in fighting nature entail changes in structure of wounds and treatment approaches.
To analyze treatment strategy and features of surgical interventions for combat gunshot head injuries considering literature data for the period from 2014 to 2020.
We analyzed the PubMed and eLibrary databases using the following keywords: head gunshot wound, traumatic brain injury, head trauma, combat trauma, wartime injury. We selected the reviews, original articles and case reports devoted to head gunshot wound management for the period 2014-2020. Manuscripts in Russian, Ukrainian and English with available abstract and/or full-text article were reviewed. Data on the incidence and structure of craniocerebral injuries, mortality and treatment strategy were analyzed.
We found 24 publications matching searching criteria. The majority of manuscripts were devoted to craniocerebral wounds received by combatants and civilians during the hostilities in the south-east of Ukraine (7 manuscripts), in Iraq and Afghanistan (4 manuscripts), as well as in the Syrian Arab Republic (12 manuscripts). Craniocerebral wounds occupy a leading position in overall structure of gunshot wounds and result the highest mortality compared to other wounds. There is a tendency towards the prevalence of bullet wounds over splinter wounds.
Modern wars and armed conflicts are characterized by changes in the structure of gunshot wounds. Craniocerebral injuries are ones of the most severe and characterized by high mortality. Data on their incidence and structure of gunshot craniocerebral wounds are advisable to be used in planning and organizing care for the wounded, as well as for development of preventive measures.
2014年至2020年期间，全球有超过15场已结束和正在进行的武装冲突。这些冲突中无法挽回的损失总数超过80万人。在现代冲突中，枪伤性头部创伤占外科领域卫生损失的37.4%。这些损伤的特点是死亡率高。战斗性质的变化导致伤口结构和治疗方法的改变。
结合2014年至2020年期间的文献数据，分析战斗性枪伤性头部创伤的治疗策略和外科干预特点。
我们使用以下关键词分析了PubMed和eLibrary数据库：头部枪伤、创伤性脑损伤、头部创伤、战斗创伤、战时损伤。我们选择了2014 - 2020年期间专门论述头部枪伤处理的综述、原创文章和病例报告。对俄语、乌克兰语和英语且有摘要和/或全文的手稿进行了审查。分析了颅脑损伤的发生率、结构、死亡率和治疗策略的数据。
我们找到了24篇符合搜索标准的出版物。大多数手稿论述的是乌克兰东南部敌对行动期间战斗人员和平民所受的颅脑创伤（7篇手稿）、伊拉克和阿富汗的（4篇手稿）以及阿拉伯叙利亚共和国的（12篇手稿）。颅脑创伤在枪伤总体结构中占据主导地位，与其他创伤相比死亡率最高。有子弹伤比碎片伤更普遍的趋势。
现代战争和武装冲突的特点是枪伤结构发生变化。颅脑损伤是最严重的损伤之一，死亡率高。关于枪伤性颅脑创伤的发生率和结构的数据应用于规划和组织伤员护理以及制定预防措施。
