头部损伤特征与军事冲突性质的关系

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头部损伤是和平时期和战争时期最严重、最复杂的创伤之一。本文研究了在多个大规模军事冲突中发生的头部损伤，并探讨了伤害部位、创伤特征与作战战术、所使用武器及地形之间的关联性。鉴于当前特殊军事行动的背景，这一分析具有重要意义，可用于个人防护装备的研发，以及战地医院中头部创伤治疗策略的制定。

本文引用了科学与专业文献，相关文献通过eLibrary、ResearchGate、CyberLeninka和PubMed数据库检索获得。在研究过程中，作者采用统计学分析、系统结构分析、描述性分析、比较、总结以及假设建构等方法。文章对叙利亚阿拉伯共和国内战（Syrian Civil War）、“伊拉克自由”（Operation Iraqi Freedom）和“持久自由”（Operation Enduring Freedom）军事行动进行了分析，并提取了损伤的平均值，将其按照受损结构类型分类展示以增强可视化效果。研究发现，头部损伤的特征因军事冲突性质不同而显著变化。然而，无论冲突类型如何，下颌,上颌，眼眶和鼻部始终是头部最易受伤的区域。

本文为医学研究领域提供了重要见解，对军医以及从事个人防护装备研发和改进的科研机构和工程技术单位的专业人员具有参考价值。

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作者简介

Maksim А. Kislov

The Russian National Research Medical University named after N.I. Pirogov

Email: kislov@sechenov.ru
ORCID iD: 0000-0002-9303-7640
SPIN 代码: 3620-8930

MD, Dr. Sci. (Medicine), Assistant Professor

俄罗斯联邦, Moscow

Evgeny Kh. Barinov

Russian University of Medicine

Email: ev.barinov@mail.ru
ORCID iD: 0000-0003-4236-4219
SPIN 代码: 2112-4568

MD, Dr. Sci (Medicine), Professor

俄罗斯联邦, Moscow

Egor А. Akulinichev

The First Sechenov Moscow State Medical University

Email: egor40rus@icloud.com
ORCID iD: 0009-0002-2142-151X
俄罗斯联邦, Moscow

Dmitriy A. Zotkin

The First Sechenov Moscow State Medical University

编辑信件的主要联系方式.
Email: zotkin.dmitriy.83@mail.ru
ORCID iD: 0000-0002-2419-5952
SPIN 代码: 9263-0002
俄罗斯联邦, Moscow

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2. Fig. 1. Foreign body and ultrafragmentary fracture with displacement of the left mandible (a ― preoperatively); restoration with screw implants and miniplates (b ― postoperative period).

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3. Fig. 2. Multiple displaced fragmentary fractures in the right mandibular branch (a ― preoperative); miniplate and screw implant in the right mandibular branch (b ― postoperative period).

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4. Fig. 3. Vectors of possible projectile and shrapnel hits to the head when using a protective helmet.

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5. Fig. 4. Effect of a low-velocity gunshot wound from a P8 pistol on tissue from a close (~4 m) distance: entry wound about 9×9 mm, medial (a); exit wound about 10×10 mm (b); pincer in the bullet canal (c), which is also detectable on the radiograph (d, arrow) due to the location of multiple small bone fragments. Palpation with a sharp spoon revealed a wound channel with a ~4–5 cm through hole in the soft tissue (Afghanistan, Kunduz Rescue Centre, July 2010).

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6. Fig. 5. Bullet and shrapnel wounds to the head and neck compared: secondary wound from a rifle shot (a); indirect facial shrapnel wound after a ‘rocket-propelled grenade’ (b). (Afghanistan, Kunduz Rescue Centre, April 2010).

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7. Fig. 6. Soft tissue and bone defect from an AK-47 assault rifle (a); preoperative (b) and postoperative (c) computed tomography.

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