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目的探讨儿童颅面穿通性损伤的临床表现及治疗原则。方法对23例儿童颅面穿通性损伤采用早期彻底清创Ⅰ期修复术。结果恢复良好者13例,轻残4例,重残3例,死亡3例。面容满意7例,基本满意9例,瘢痕挛缩3例,塌陷(去骨板减压)l例。14例脑脊液漏术后2～27d停止,1例经再次手术治愈。随访6个月～11年未见癫痫发作,无一例发生颅内感染和创面局部伤口感染。结论经眶部穿通伤是颅面穿通伤的最常见类型;儿童颅面穿通性损伤死亡和残废率高,救治难度大,应重视病史及生命体征变化,妥善处理脑损伤,尽早彻底清创Ⅰ期手术修复。
Objective To investigate the clinical manifestations and treatment principles of craniofacial penetrating injury in children. Methods 23 cases of craniofacial penetrating injury in children with early complete debridement Ⅰ repair. Results In 13 cases with good recovery, 4 cases were mild disability, 3 cases severe disability and 3 cases died. Face satisfaction in 7 cases, 9 cases of basic satisfaction, scar contracture in 3 cases, collapse (de-bone plate decompression) in 1 case. 14 cases of cerebrospinal fluid leakage after 2 ~ 27d stop, 1 case was cured again. Follow-up 6 months to 11 years without seizures, no case of intracranial infection and wound wound infection. CONCLUSIONS: Perforation of the orbit is the most common type of craniofacial penetrating injury. Children with craniofacial penetrating injury have high rates of death and malalignment. It is difficult to treat and treat the patients. Pay attention to the changes of their medical history and vital signs, properly deal with brain injury and debridement as soon as possible. Period of surgical repair.