目的

探讨下颌骨枪伤的致伤机理、临床特点及诊疗方法，拟提高对该病的认识及诊治水平。

方法

结合广东省揭阳市人民医院收治的1 例下颌骨颏部及体部粉碎性骨折合并手枪弹头存留的病例，复习相关文献，对下颌骨枪弹外伤进行初步的探讨。

结果

经对症支持治疗，积极治疗全身疾病后，手术取出存留弹头及移位感染的骨碎片，下颌骨复位固定，15 d 后患者痊愈出院。

结论

枪伤不同于一般的创伤，不但可致局部损伤，尚可发生远部脏器并发损伤，其机制尚未完全阐明，救治时应重点处理局部伤口，同时密切关注全身情况。

Objective

To study of mandibular gunshot wounds mechanisms，clinical characteristics and therapeutic methods， in order to improve the diagnosis and treatment.

Methods

A case of police pistol induced mandibular comminuted fracture and bullet remaining was analyzed， and the related literatures were reviewed. The patient， male， 32 years old， was diagnosed as mandible comminuted fracture and bullet retention. A standard tracheotomy was done immediately after the patient reaching hospital， and then was symptomatic treated. The onsets of pleural effusion， uremia and severe anemia were three days after hospitalization.

Results

The operation of removing the remaining bullet and mandible reduction and fixation were performed after active treatment of systemic diseases. Half a month later， the patient recovered.

Conclusions

Gunshot wounds was different from the general trauma， it could cause not only local damage， but also distal organ injury. The mechanisms have not been fully elucidated， and the treatments should not only focus on dealing with local wounds， also should pay close attention to general situation.