癫痫发作致重度烧伤的综合治疗

目的总结分析癫痫发作致重度烧伤患者的救治经验，以进一步提高治愈率和减少致残率。方法回顾分析1990～2006年我科收治的因癫痫发作致重度烧伤（烧伤总面积〉30％或Ⅲ°烧伤面积〉10％）患者57例，以1998年1月1日为界分为两组，两组病情具有可比性，1998年后广泛应用新的综合治疗措施，主要为有效充分液体复苏、早期胃肠道营养、早期积极行切削痂植皮和转移皮瓣封闭创面。结果1998年后患者（B组）脓毒症和多器官功能障碍综合征（MODS）的发生率明显低于1998年以前患者（A组）；B组平均住院天数明显短于A组；B组住院期间癫痫再发生率明显低于A组：B组创面愈合后残疾率明显低于A组。结论早期充分有效液体复苏、胃肠道营养、积极切削痂植皮和转移皮瓣封闭创面能降低重度癫痫烧伤患者并发症的发生、缩短病程，减少死亡率、致残率和住院期间癫痫再发生率。

Combined therapy of severe burn induced by epileptic seizure

Objective To summarize the experience of management in epileptics with severe bum （burned area exceeding 30% or Ⅲ°area exceeding 10% ）in order to raise cure rate and decrease disability rate.Methods 57 epileptics with severe bum were retrospectively analyzed in our department from 1990 to 2006.Patients were divided into two groups according to the admission date,before and after January 1,1998 since new management was extensively applied after 1998.These measures consisted of rapid and adequate fluid resuscitation ,early enteral feeding, autograft after eschar excision or eschar shaving and flap grafting.Results The incidence of sepsis , multiple organ dysfunction syndrome （MODS）, disability and epilepsia in duration of hospital stay after 1998 was obviously lower than that of the group before 1998, hospital day of patients after 1998 was significantly shortened.Conclusion The new therapy applied in serious burned patients with epilepsy can reduce the occurrence of complications and disability, shorten the course of treatment , increase the cure rate,decrease death rate and recurrence of epilepsia in duration of hospital stay.