CAJ | 학술논문

1 病历摘要患者男,28岁.在约8 m高处作业时双手不慎与10 kV高压电线接触,致身体多处烧伤并坠落,着地后昏迷约10 min.被送至当地医院治疗,CT检查示双侧枕部硬脑膜外血肿、左侧枕叶挫裂伤,给予抗休克、左上肢切开减张等治疗.伤后5d转入我院.患者入院时意识清楚,精神差,诉头痛、视物模糊；创面分布于头颈项部、双手、左前臂及左肩部,枕部约有5 cm×4 cm头皮缺损,颅骨外露且部分炭化,周围见约10 em宽皮革样焦痂.入院诊断:(1)高压电烧伤,总面积为6％,其中深Ⅱ度1％、Ⅲ度1％、Ⅳ度4％ TBSA (2)双侧枕部硬脑膜外血肿,左侧枕叶脑挫裂伤,部分硬脑膜缺损,部分颅骨全层坏死.见图1.伤后14 d头颅CT检查结果见图2.
1 병력적요환자남,28세.재약8 m고처작업시쌍수불신여10 kV고압전선접촉,치신체다처소상병추락,착지후혼미약10 min.피송지당지의원치료,CT검사시쌍측침부경뇌막외혈종、좌측침협좌렬상,급여항휴극、좌상지절개감장등치료.상후5d전입아원.환자입원시의식청초,정신차,소두통、시물모호；창면분포우두경항부、쌍수、좌전비급좌견부,침부약유5 cm×4 cm두피결손,로골외로차부분탄화,주위견약10 em관피혁양초가.입원진단:(1)고압전소상,총면적위6％,기중심Ⅱ도1％、Ⅲ도1％、Ⅳ도4％ TBSA (2)쌍측침부경뇌막외혈종,좌측침협뇌좌렬상,부분경뇌막결손,부분로골전층배사.견도1.상후14 d두로CT검사결과견도2.
This article reports the treatment of a patient suffering from full-thickness electric burn of skull combined with cerebral contusion and intracranial infection to provide experience in treating such patients.Based on detailed analysis on patient's condition and CT results,several operations of surgery and anti-infection treatment were performed on the patient.The wounds healed 6 weeks after injury. The skull defect was repaired with three-dimensionally reconstructed titanium mesh of computer-aided design two years after wound healing.The treatment of full-thickness electric burn of skull combined with cerebral contusion was quite difficult.The timing and mode of operation were very important.Perioperative prevention and treatment of intracranial infection were essential to save the life of the patient.In the event of intracranial infection,effective systemic use of antibiotics,cerebrospinal fluid drainage,intrathecal injection of drugs, and the application of other comprehensive measures could ensure the success of treatment.