Dodge G G, Cogbill T H, Miller G J, Landercasper J, Strutt P J
Department of Surgery, Gundersen Clinic, Ltd., La Crosse, Wisconsin 54601.
Am Surg. 1994 Jun;60(6):401-4.
The 10-year experience of a Level II trauma center with 122 gunshot wounds referred from a large rural area was analyzed to illustrate differences from the experience of urban centers. Most frequent causes of injury were attempted suicide in 38 (31%) patients, hunting mishaps in 32 (26%), unintentional accidents in 29 (24%), and intentional assault in 18 (15%). Of weapons specified, rifles were documented in 48 (39%) instances, shotguns in 25 (21%), and handguns in 24 (20%). Body regions injured were the trunk in 47 (39%) patients, head in 35 (29%), lower extremity in 31 (25%), and upper extremity in 29 (24%). Twenty-five patients (20%) died as a result of their injuries. The cause of death was brain injury in 18 (72%), exsanguination from truncal wounds in 5 (20%), myocardial infarction in 1 (4%), and multiple organ failure in 1 (4%). We conclude that the distributions of cause and type of gunshot wounds are unique in a rural setting. These differences have profound consequences in designing effective prevention programs for our area and support the design of more efficient trauma systems for rural North America.
对一家二级创伤中心接收的来自广大农村地区的122例枪伤患者的10年经验进行了分析，以阐明与城市中心经验的差异。最常见的受伤原因是38例（31%）患者自杀未遂，32例（26%）狩猎事故，29例（24%）意外事故，以及18例（15%）故意袭击。在明确的武器类型中，步枪有记录的为48例（39%），霰弹枪为25例（21%），手枪为24例（20%）。受伤的身体部位中，47例（39%）患者为躯干，35例（29%）为头部，31例（25%）为下肢，29例（24%）为上肢。25例患者（20%）因伤死亡。死亡原因是脑损伤18例（72%），躯干伤口失血5例（20%），心肌梗死1例（4%），多器官功能衰竭1例（4%）。我们得出结论，农村地区枪伤的原因和类型分布具有独特性。这些差异对为我们地区设计有效的预防方案具有深远影响，并支持为北美农村地区设计更高效的创伤系统。
