目的　探讨鞍区颅脑枪击伤急性期的救治及晚期鞍区金属异物摘除的方法。　方法　对 7例鞍区颅脑枪击伤患者行早期清创术 ,3例患者同时摘除金属异物 ;4例患者晚期采用显微手术摘除下丘脑、垂体内金属弹丸。所有患者均获随访 ,随访时间 3～ 11年。　结果　全部患者均康复 ,无下丘脑或垂体功能障碍。恢复良好 3例 ,轻残 3例 ,重残 1例。　结论　鞍区颅脑枪击伤患者 ,应早期行清创术 ,尽可能摘除金属异物 ,修补颅底脑膜防止脑脊液漏。术后加强抗感染、抗脑水肿治疗。重症患者需及时治疗继发性脑损害 ,积极治疗内分泌紊乱等并发症 ,在全身情况稳定后 ,采用显微手术摘除异物。显微手术对摘除脑深部重要部位的金属异物是一安全可靠的方法 Objective To investigate the treatment of craniocerebral gunshot wounds in sellar region and the removal of metal foreign bodies in advanced sellar regions. Methods Early debridement was performed on 7 cases of craniocerebral gunshot wound in the sellar region and 3 cases of metal foreign bodies were simultaneously removed. In 4 cases, microsurgical removal of the hypothalamus and pituitary metal prolapse was performed in the late stage. All patients were followed up for 3 to 11 years. Results All patients recovered without hypothalamic or pituitary dysfunction. 3 cases were recovered well, 3 cases were mild disability and 1 case was disability. Conclusion In craniofacial craniofacial injury patients, debridement should be performed early, as much as possible to remove metal foreign body, repair of skull basement membrane to prevent cerebrospinal fluid leakage. Postoperative anti-infection, anti-cerebral edema treatment. Severe patients need timely treatment of secondary brain damage, aggressive treatment of endocrine disorders and other complications, the general condition is stable, the use of microsurgical removal of foreign body. Microsurgery is a safe and reliable method for the removal of metallic foreign bodies in deep parts of the brain