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小儿严重烧伤后由于皮肤的屏障功能丧失和微血管通透性增加 ,大量体液和蛋白质从创面丢失 ,引起低蛋白血症及有效循环锐减 ,极易休克 ,小儿的神经组织尚未发育完善 ,对缺氧耐受差 ,因而小儿严重烧伤后极易并发脑水肿。小儿严重烧伤后脑水肿后果严重 ,由此引起的缺血缺氧性损害及失控性炎症反应是严重烧伤后脏器损害的首发因素。由于烧伤本身急性危重的临床症状或其它并发症将其掩盖 ,给严重烧伤后并发脑水肿的早期诊治带来困难。脑水肿严重者有可能导致颅内压增高及形成脑疝。脑疝一旦形成 ,患者病死率极高。本文就目前小儿严重烧伤并发脑水肿的病因和发病机理、临床表现和诊断、治疗及预防现状作一综述
Serious burns in children due to the loss of the barrier function of the skin and increased microvascular permeability, a large number of body fluids and proteins lost from the wound, causing hypoproteinemia and the effective reduction of circulation, easily shock, the child’s nervous tissue has not yet developed and perfect, Oxygen tolerance is poor, so children with severe burns easily complicated by cerebral edema. Serious brain injury in children with severe cerebral edema, resulting in hypoxic-ischemic damage and uncontrolled inflammatory response is a serious burn organ damage after the first factor. Due to the acute and critical clinical symptoms or other complications of the burn itself, it is difficult to cover the early diagnosis and treatment of severe post-burn cerebral edema. Severe cerebral edema may lead to increased intracranial pressure and the formation of cerebral hernia. Once a herniation is formed, the patient has a high case fatality rate. This article reviews the current etiology and pathogenesis, clinical manifestations and diagnosis, treatment and prevention status of severe brain injury in children with cerebral edema