| 尚新志,杜晨飞,孟进松,林之琛.婴幼儿烧伤早期惊厥的原因分析及处理对策[J].中国烧伤创疡杂志,2016,(1):18~21. |
| DOI： |
| 中文关键词: 惊厥 烧伤早期 婴幼儿 病因 对症治疗 |
| 英文关键词:Convulsion Early stage of burns Infant Cause Symptomatic treatment |
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| 中文摘要: |
| 目的 探讨婴幼儿烧伤早期惊厥的发病原因及处理对策。方法 回顾性分析中国人民解放军第159医院烧伤科2005年1月－2014年1月收治的328例烧伤早期发生惊厥患儿的病历资料，分析其原因及处理对策。结果 4890例烧伤患儿中有328例在烧伤早期发生惊厥，惊厥发生率为6.7％。惊厥发生率与病情轻重有关：中、重度烧伤早期的惊厥发生率较低，共34例，占10.4％，特重度烧伤早期的惊厥发生率较高，共294例，占89.6％；本组328例惊厥患儿以深Ⅱ度和Ⅲ度烧伤为主，而同期未发生惊厥的烧伤患儿以浅Ⅱ度和深Ⅱ度烧伤为主。惊厥的发生原因主要包括：脑水肿109例，占33.2％；低血容量休克35例，占10.7％；电解质紊乱74例，占22.6％；高热惊厥89例，占27.1％；感染13例，占4.0％；癫痫8例，占2.4％。经过积极对症治疗，除8例患儿因多种原因抢救无效死亡外，其余320例患儿均被治愈。结论 烧伤的严重程度与惊厥的发生率成正相关，补液失当引起的脑水肿、电解质紊乱及低血容量休克是造成婴幼儿烧伤早期惊厥发生的最主要原因，而毒素吸收、创面感染及疼痛刺激等引起的高热是次要原因，合并破伤风及其他基础疾病时更易发生惊厥。合理补液，预防高热及积极治疗并发症是防治婴幼儿烧伤早期惊厥的关键。 |
| 英文摘要: |
| Objective To explore causes and countermeasures of convulsions at the early stage of infantile burns. Methods Retrospectively analyze the case data of 328 infants with convulsions at the early stage of burn wounds admitted in Burns Department of The 159th Hospital of People’s Liberation Army between January 2005 and January 2014 to clarify the causes and countermeasures. Results Of 4890 burned infants, 328 cases developed convulsions at the early stage of burn wounds, with the incidence rate of 6.7%. The incidence rate of convulsion was associated with disease severity: The incidence rate of convulsion at the early stage of moderate and severe burn wounds was lower, with 34 cases accounting for10.4%, and that of extraordinarily severe burn wounds was higher, with 294 cases, accounting for 89.6%; The included 328 cases with convulsions were mainly deep second?degree and third?degree burns while the burned infants without convulsions at the corresponding period were mainly superficial second?degree and deep second?degree burns. The causes of convulsions mainly included: 109 cases of cerebral edema, accounting for 33.2%; 35 cases of hypovolemic shock, accountingfor 10.7%; 74 cases of electrolyte disturbance, accounting for 22.6%; 89 cases of febrile convulsion, accounting for 27.1%; 13 cases of infection, accounting for 4.0%; 8 cases of epilepsy, accounting for 2.4%. After the active symptomatic treatment, 320 cases of burned infants were cured and 8 cases were died due to different reasons. Conclusion The severity of burns is positively correlated with the incidence rate of convulsion. Cerebral edema, electrolyte disturbance and hypovolemic shock caused by improper fluid resuscitation are the main causes of convulsion at the early stage of burns, while high fever caused by toxin absorption, wound infection and pain stimulation is the secondary cause. The convulsion is likely to occur while the patients were complicated with tetanus and other underlying diseases. The key measures to prevent convulsion at the early stage of infantile burns are proper fluid resuscitation, prevention of high fever and active treatment of complications. |
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