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由于高速弹片或枪弹所致的颌面伤,投射物穿过鼻腔,不论投射物存留与否,极易造成鼻腔粘连。在颌面中部骨折的伤员,往往由于鼻窦骨折后的碎片嵌顿于鼻腔而形成骨性粘连。此种骨性粘连,需采用手术方法进行松解,手术径路以采用经硬腭较为方便。本文报告1例鼻腔后部骨性粘连的伤员,经硬腭径路行手术松解治愈,术后已随访10个月,现报告如下。伤员刘某,男性,19岁,广东籍,战士,1979年3月4日入院。伤员于1979年2月27日在对越自卫还击战中被弹片击伤面部,弹片自右耳前进入,出口位于左颧颞部。当时伤员昏迷、出血、鼻阻塞、张口呼吸,76小时后到第一线医院清创及抗感染治疗,伤后6天送到本院。体检时发现右耳前及左颧颞部的创口已渐愈合,左眼失明,瞳孔散大。鼻腔检查:前鼻镜见两下甲前部充血肿胀,鼻腔内充满黄色粘液样分泌物,双侧鼻腔后部均为红色粗糙
Due to high-speed shrapnel or bullets caused by maxillofacial injury, projectile through the nasal cavity, regardless of projectile stay or not, can easily cause nasal adhesions. In the maxillofacial fracture of the wounded, often due to fragments of the sinus after incarcerated in the nasal cavity and the formation of bone adhesions. Such bony adhesions, the need for surgical methods for release, surgical approach to the adoption of the hard palate more convenient. This article reports a case of nasal posterior osseous adhesions wounded by the palatal pathology surgery to release the cure postoperative follow-up of 10 months, are as follows. Wounded Liu, male, 19 years old, Guangdong nationality, soldier, March 4, 1979 admitted. On February 27, 1979, the wounded were struck by a shrapnel on the face of a self-defending fight against Vietnam. The shrapnel entered from the right ear and the exit was located in the left zygomatic temporal region. At that time, the wounded coma, bleeding, nasal obstruction, mouth breathing, debridement and anti-infective treatment to the first-line hospital 76 hours later, to the hospital 6 days after injury. Physical examination found that the right ear and left zygomatic temporal wounds have gradually healed, left eye blindness, mydriasis. Nasal examination: see the front of the nose before the two under a congestion and swelling of the nasal cavity filled with yellow mucus-like secretions, both sides of the rear nasal red roughening