Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi

ÜNAL, Faruk; CANSEVER, Tufan; KARASU, Aykut; İMER, Murat; Sabancı, Pulat Akın; Sencer, Altay; KIRIS, TALAT; ORAN, Emre

Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi

Aykut KARASU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Tufan CANSEVER, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Pulat Akın SABANCI, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Talat KIRIŞ, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Murat İMER, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Emre ORAN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Altay SENCER, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Faruk ÜNAL (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Nöroşirurji Anabilim Dalı, İstanbul, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

2 0

Yıl: 2008 Cilt: 14 Sayı: 1 Sayfa Aralığı: 59 - 64 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi

Öz:

Bu çal›flmada, hastanemizin Acil Cerrahi ve Travmatoloji Klini¤ i’nde 1997-2006 yılları arasında kranyoserebral ateflli silah yaralanmaları nedeniyle tedavi edilen sivil olgularda sonuçlarımızı belirleyen faktörler saptanarak, klinik deneyimlerimiz do¤rultusunda sonuçlar ve cerrahi strateji gözden geçirildi. GEREÇ VE YÖNTEM Ateflli silahla kranyoserebral yaralanma nedeniyle tedavi edilen 82 sivil olguda (74 erkek, 8 kad›n) klinik ve radyolojik bulgular geriye dönük olarak kaydedildi. Nörolojik ve fiziksel incelemeleri, kranyal bilgisayarlı tomografi (KBT) bulguları, yaralanma flekilleri, tedavi yöntemleri, prognoz, komplikasyon, morbidite ve mortalite oranları incelendi. BULGULAR Hastaların 74’ü (%90) erkekti ve yafl ortalaması 29,2 idi. Hastaneye kabul sırasındaki gelifl nörolojik muayeneleri incelendi¤inde Glasgow Koma Skalası (GKS) de¤erlerinin sırasıyla; hastalar› n 35’inde 3-5, 9’unda 6-8, 19’unda 9-12, 19’unda 13-15 aras›nda oldu¤u saptand›. Radyolojik inceleme bulguları sonucunda en sık, subdural hematom, intraserebral hematom, çoklu kontüzyonlar, çökme k›r›¤›, subaraknoidal kanama saptandı. Toplam 51 hastada ameliyat ve debridman yapıldı. K›rk bir olgu kaybedildi. Toplam mortalite oranı 82 hastada %50 olarak belirlendi. SONUÇ Ateflli silahla kranyal yaralanma olgularında mortalite yüksektir. Hastaneye gelifl muayenelerinde GKS 8’in üzerinde ve tek hemisferi ilgilendiren yaralanması olan olgularda prognoz daha iyidir. Tüm hastalarda debridman yapılmasının, intrakranyal kitle etkisi saptanan hastalarda erken cerrahinin faydalı oldu¤ u sonucuna var›ldı.

Anahtar Kelime: Tıbbi kayıtlar Yaralanma şiddeti skoru Acil tedavi Acil servis, hastane Kranioserebral travma Glasgow koma skalası Tomografi, x-ışınlı bilgisayarlı Ölüm oranı Yaralar, ateşli silah Geriyedönük çalışma

Konular: Periferik Damar Hastalıkları Tıbbi Araştırmalar Deneysel Acil Tıp Cerrahi

Craniocerebral civilian gunshot wounds: one hospital's experience

Öz:

In this study we have discussed the factors that affect our surgical results according to our experience on patients who were admitted to our hospital’s Emergency Surgery Department for civilian craniocerebral gunshot wounds between 1997 and 2006. METHODS The clinical and radiological findings of 82 patients (74 males, 8 females) who were treated for civilian craniocerebral gunshot wounds were retrospectively recorded. Neurological and physical examination, cranial computerized tomography (CCT) findings, trauma types, treatment modalities, prognosis, complications, morbidity and mortality rates were analyzed. RESULTS Seventy-four (90%) of the patients were male, the mean age was 29.2 year. The Glasgow Coma Scores (GCS) during admission were as following respectively: 3-5 in 35 patients, 6- 8 in 9 patients, 9-12 in 19 patients and 13-15 in 19 patients. According to their radiological findings, most commonly subdural hematoma, intracerebral hematoma, multiple contusion, depressed fracture and subarachnoidal hematoma were encountered. Operation or debridement was performed in 51 patients totally. Forty-one patients died and the mortality rate of 82 patients was calculated as 50%. CONCLUSION The mortality rate of craniocerebral gunshot wound is high. The patients with GCS higher than 8 and with unihemispheric lesions during admission have better prognosis. We concluded that all patients must undergo debridement and the patients that have mass effect must be operated as soon as possible.

Anahtar Kelime: Wounds, Gunshot Retrospective Studies Medical Records Injury Severity Score Emergency Treatment Emergency Service, Hospital Craniocerebral Trauma Glasgow Coma Scale Tomography, X-Ray Computed Mortality

Konular: Periferik Damar Hastalıkları Tıbbi Araştırmalar Deneysel Acil Tıp Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KARASU A, CANSEVER T, Sabancı P, KIRIS T, İMER M, ORAN E, Sencer A, ÜNAL F (2008). Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. , 59 - 64.
Chicago	KARASU Aykut,CANSEVER Tufan,Sabancı Pulat Akın,KIRIS TALAT,İMER Murat,ORAN Emre,Sencer Altay,ÜNAL Faruk Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. (2008): 59 - 64.
MLA	KARASU Aykut,CANSEVER Tufan,Sabancı Pulat Akın,KIRIS TALAT,İMER Murat,ORAN Emre,Sencer Altay,ÜNAL Faruk Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. , 2008, ss.59 - 64.
AMA	KARASU A,CANSEVER T,Sabancı P,KIRIS T,İMER M,ORAN E,Sencer A,ÜNAL F Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. . 2008; 59 - 64.
Vancouver	KARASU A,CANSEVER T,Sabancı P,KIRIS T,İMER M,ORAN E,Sencer A,ÜNAL F Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. . 2008; 59 - 64.
IEEE	KARASU A,CANSEVER T,Sabancı P,KIRIS T,İMER M,ORAN E,Sencer A,ÜNAL F "Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi." , ss.59 - 64, 2008.
ISNAD	KARASU, Aykut vd. "Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi". (2008), 59-64.

APA	KARASU A, CANSEVER T, Sabancı P, KIRIS T, İMER M, ORAN E, Sencer A, ÜNAL F (2008). Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. Ulusal Travma ve Acil Cerrahi Dergisi, 14(1), 59 - 64.
Chicago	KARASU Aykut,CANSEVER Tufan,Sabancı Pulat Akın,KIRIS TALAT,İMER Murat,ORAN Emre,Sencer Altay,ÜNAL Faruk Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. Ulusal Travma ve Acil Cerrahi Dergisi 14, no.1 (2008): 59 - 64.
MLA	KARASU Aykut,CANSEVER Tufan,Sabancı Pulat Akın,KIRIS TALAT,İMER Murat,ORAN Emre,Sencer Altay,ÜNAL Faruk Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. Ulusal Travma ve Acil Cerrahi Dergisi, vol.14, no.1, 2008, ss.59 - 64.
AMA	KARASU A,CANSEVER T,Sabancı P,KIRIS T,İMER M,ORAN E,Sencer A,ÜNAL F Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. Ulusal Travma ve Acil Cerrahi Dergisi. 2008; 14(1): 59 - 64.
Vancouver	KARASU A,CANSEVER T,Sabancı P,KIRIS T,İMER M,ORAN E,Sencer A,ÜNAL F Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi. Ulusal Travma ve Acil Cerrahi Dergisi. 2008; 14(1): 59 - 64.
IEEE	KARASU A,CANSEVER T,Sabancı P,KIRIS T,İMER M,ORAN E,Sencer A,ÜNAL F "Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi." Ulusal Travma ve Acil Cerrahi Dergisi, 14, ss.59 - 64, 2008.
ISNAD	KARASU, Aykut vd. "Kranyoserebral ateşli silah yaralanmaları: bir hastanenin deneyimi". Ulusal Travma ve Acil Cerrahi Dergisi 14/1 (2008), 59-64.