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[枪伤——弹道学、病理生理学、外科治疗]

[Gunshot wounds--ballistics, physiopathology, surgical treatment].

作者信息

Bonath K H, Vannini R, Koch H, Schnettler R

机构信息

Allgemeinen und Experimentellen Chirurgie, Justus-Liebig-Universität Giessen.

出版信息

Tierarztl Prax. 1996 Jun;24(3):304-15.

PMID:8767194
Abstract

The form and size of gunshot wounds depend on the projectile type (bird shot, deforming projectiles, non-deforming projectiles), its velocity at impact (high or low velocity projectiles) and the type of tissue affected by the projectile (soft tissues, bones). Gunshot wounds are always contaminated. While low velocity projectiles usually cause minimal wounds, high velocity projectiles can cause large, devastating wounds. All projectiles fired from firearms have a high velocity on impact and may cause death by traumatic shock instantaneously. Ballistics, pathophysiology and clinical findings of gunshot wounds are discussed, forensic aspects are mentioned. Gunshot wounds are often emergencies. Lifesaving and -stabilizing treatment is most important. A treatment plan aiming at preventing possible complications such as infections and functional disturbances is given for different types of gunshot wounds. Systemic lead poisoning has not been investigated sufficiently. Projectiles usually become encapsulated. The search for projectiles is associated with an additional surgical trauma and usually indicated only for joint wounds (lead arthropathy).

摘要

枪伤的形态和大小取决于射弹类型(霰弹、变形射弹、非变形射弹)、撞击时的速度(高速或低速射弹)以及受射弹影响的组织类型(软组织、骨骼)。枪伤总是被污染的。低速射弹通常造成的伤口较小,而高速射弹可导致巨大的毁灭性伤口。所有从火器发射的射弹在撞击时速度都很高,可能会因创伤性休克瞬间导致死亡。文中讨论了枪伤的弹道学、病理生理学和临床发现,并提及了法医方面的内容。枪伤往往属于急症。挽救生命和稳定病情的治疗最为重要。针对不同类型的枪伤给出了一个旨在预防诸如感染和功能障碍等可能并发症的治疗方案。全身性铅中毒尚未得到充分研究。射弹通常会被包裹起来。寻找射弹会带来额外的手术创伤,通常仅适用于关节伤口(铅中毒性关节炎)。

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