Khedr E M, Khedr T, el-Oteify M A, Hassan H A
Department of Neurology, Faculty of Medicine, Assiut University, Egypt.
Burns. 1997 Nov-Dec;23(7-8):579-83. doi: 10.1016/s0305-4179(97)00068-5.
Neuropathy in burn patients is frequently overlooked. This study aimed at looking for neuropathies among burn patients. It included 55 burn patients, whether symptomatic or asymptomatic, with variable depths of burn at different stages. Their ages ranged from 8 to 55 years with a mean age of 23.6 +/- 11.1 years. All patients were submitted to clinical examination, electromyographic and motor conduction velocities of burned and unburned limbs. Serum electrolyte, blood urea and creatinine were measured for all patients. Sixteen patients (29 per cent) had peripheral neuropathy. Only six had symptoms and signs of peripheral neuropathy. The most frequently diagnosed neuropathy in this study was mononeuritis multiplex in nine patients (56 per cent), then generalized distal axonal neuropathy in five patients (31 per cent) and entrapment neuropathy in two patients (13 per cent). In patients with mononeuritis, 29 nerves were affected, 24 nerves related to the site of the burn and five nerves were away from the site of the burn. All the entrapment neuropathy developed after wound healing. Age above 20 years, electric burns burns involving full thickness of the skin and a surface area of more than 20 per cent were associated with a significantly higher prevalence of neuropathy. Other parameters were not found to be significant in the development of neuropathy.
烧伤患者的神经病变常常被忽视。本研究旨在探寻烧伤患者中的神经病变情况。研究纳入了55例烧伤患者，包括有症状和无症状的患者，处于不同阶段且烧伤深度各异。他们的年龄在8至55岁之间，平均年龄为23.6±11.1岁。所有患者均接受了临床检查、烧伤及未烧伤肢体的肌电图和运动传导速度检测。对所有患者测量了血清电解质、血尿素和肌酐。16例患者（29%）患有周围神经病变。仅有6例有周围神经病变的症状和体征。本研究中最常诊断出的神经病变是多发性单神经炎，共9例（56%），其次是广泛性远端轴索性神经病变5例（31%）和卡压性神经病变2例（13%）。在患有多发性单神经炎的患者中，29条神经受到影响，其中24条神经与烧伤部位相关，5条神经与烧伤部位无关。所有卡压性神经病变均在伤口愈合后出现。20岁以上、涉及全层皮肤的电烧伤以及烧伤面积超过20%与神经病变的患病率显著升高相关。未发现其他参数在神经病变的发生中具有显著意义。
