ผลการศึกษาภาวะบาดเจ็บศีรษะจากกระสุนปืนในโรงพยาบาลนครปฐม

บทคัดย่อ

Objective : To study patients’ informations, prognostic factors, results and management in craniocerebral gunshot wounds in Nakhonpathom Hospital.

Material and Method : Retrospective study of craniocerebral gunshot wounds in Nakhonpathom Hospital since 2004-2009 were done by reviewing medical record and computerized tomography of the brain of each patient. Overall patients in this study were 13 (Male 11, Female 2). Assessment by Glasgow Outcome Scale Score, mortality, survival rate and prognostic factors were observed.

Result : 5 patients were died after surgical management (5 in total 13 patients). Mortality rate was 38%. lt was found that Group of Glasgow Coma Score lower than 8 had poor prognosis, no matter surgery was done. Mortality rate was 57% in this group and 43% of disabilities. Abnormal pupillary light reaction was also found in group of poor Glasgow Coma Score. Monality rate was demonstrated higher in group of bullet tract that crossed midsagittal or midcoronal plane of the brain.

Conclusions : This study disclosed that Glasgow Coma Score, abnormal pupillary light reaction and bullet tract that crossed midplane affected the outcome. The outcome in group of low Glasgow Coma Score was poor, eventhough surgery was early performed but there was no conclusions whether surgery should or should not be done in any groups. It still depended on neurosurgeon's judgements in each patient.