Stone J L, Lichtor T, Fitzgerald L F
Division of Neurosurgery, Cook County Hospital, Chicago, Illinois, USA.
Neurosurgery. 1995 Dec;37(6):1104-10; discussion 1110-2. doi: 10.1227/00006123-199512000-00010.
An aggressive surgical strategy was applied to cranial gunshot wound victims at Cook County Hospital in Chicago from 1983 to 1992. A series of 480 patients with an overall mortality rate of 34% is presented. A total of 150 patients underwent craniotomy with an operative mortality rate of 21%. Criteria for operation were Glasgow Coma Scale scores of 3 through 7 without hypotension or fixed and dilated pupils or Glasgow Coma Scale scores of 8 through 15 with intracranial bone fragments or significant clot. This study supports previous reports that even patients with severe neurological deficits and massive cerebral damage can benefit from aggressive treatment and make satisfactory recoveries.
1983年至1992年期间，芝加哥库克县医院对颅脑枪伤患者采用了积极的手术策略。本文报告了一系列480例患者，总体死亡率为34%。共有150例患者接受了开颅手术，手术死亡率为21%。手术标准为格拉斯哥昏迷量表评分为3至7分且无低血压或瞳孔固定及散大，或格拉斯哥昏迷量表评分为8至15分且伴有颅内骨碎片或大量血凝块。本研究支持先前的报告，即即使是有严重神经功能缺损和大面积脑损伤的患者也能从积极治疗中获益并获得满意的恢复。
