Gaboriau H P, Kreutziger K L
Department of Otolaryngology/Head and Neck Surgery, Tulane University Medical School, New Orleans, La., USA.
J La State Med Soc. 1998 Jan;150(1):6-9.
In dealing with gunshot wounds to the face, the emergency department physician should have a basic knowledge of ballistics. Securing an airway (either intubation or surgical airway) should be the top priority. The location of the wound dictates which patient should be intubated. Plain x-ray films of the face and skull, as well as CT scan in certain situations, allow determination of the extent of damages to the skeleton as well as intracranial injuries. Clinical symptoms suggesting an underlying vascular injury require an angiogram. After thorough debridement of the wounds, fractures are treated either with open-reduction and internal fixation or closed-reduction and intermaxillary fixation.
在处理面部枪伤时，急诊科医生应具备弹道学的基本知识。确保气道通畅（无论是插管还是建立外科气道）应是首要任务。伤口的位置决定了哪些患者需要插管。面部和颅骨的普通X线片，以及在某些情况下的CT扫描，有助于确定骨骼损伤的程度以及颅内损伤情况。提示潜在血管损伤的临床症状需要进行血管造影。在对伤口进行彻底清创后，骨折可采用切开复位内固定或闭合复位颌间固定进行治疗。
