中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2010年
17期
2311-2313
,共3页
吴祖煌%宋斌%陈国养%卓燕舞
吳祖煌%宋斌%陳國養%卓燕舞
오조황%송빈%진국양%탁연무
烧伤%早期肠内营养%生长激素%烧伤脓毒症
燒傷%早期腸內營養%生長激素%燒傷膿毒癥
소상%조기장내영양%생장격소%소상농독증
Burn%Early enteral nutrition%Recombinant human growth hormone%Burn sepsis
目的 探讨早期肠内营养联合生长激素在危重烧伤患者救治中的作用.方法 将35例严重烧伤(30%～50%TBSA)患者,随机分成肠内营养组(EN组)和肠外营养组(PN组),对比分析两组前白蛋白(PA)、肿瘤坏死因子(TNFα)、空腹微量血糖水平、创面愈合时间、平均住院时间、烧伤脓毒症发生率、应激性溃疡出血和早期胃肠道不耐受的发生率.结果 EN平均住院时间较PN组缩短.PN组出现烧伤脓毒症、应激性溃疡和早期胃肠营养不耐受发生率较EN组为高(P<0.05).PN组及EN组PA均明显下降,但PN下降更为明显(P<0.05).PN组及EN组空腹血糖水明显上升,但EN上升更为明显(P<0.05).EN组及PN组CRP、TNFα均明显升高,但以PN组升高为著(P<0.01).EN组供皮区、植皮区、深Ⅱ度创面较组缩小(P<0.01).结论 早期肠内营养联合生长激素能明显改善患者营养状况,降低脓毒症和应激性溃疡等并发症的发生率.
目的 探討早期腸內營養聯閤生長激素在危重燒傷患者救治中的作用.方法 將35例嚴重燒傷(30%～50%TBSA)患者,隨機分成腸內營養組(EN組)和腸外營養組(PN組),對比分析兩組前白蛋白(PA)、腫瘤壞死因子(TNFα)、空腹微量血糖水平、創麵愈閤時間、平均住院時間、燒傷膿毒癥髮生率、應激性潰瘍齣血和早期胃腸道不耐受的髮生率.結果 EN平均住院時間較PN組縮短.PN組齣現燒傷膿毒癥、應激性潰瘍和早期胃腸營養不耐受髮生率較EN組為高(P<0.05).PN組及EN組PA均明顯下降,但PN下降更為明顯(P<0.05).PN組及EN組空腹血糖水明顯上升,但EN上升更為明顯(P<0.05).EN組及PN組CRP、TNFα均明顯升高,但以PN組升高為著(P<0.01).EN組供皮區、植皮區、深Ⅱ度創麵較組縮小(P<0.01).結論 早期腸內營養聯閤生長激素能明顯改善患者營養狀況,降低膿毒癥和應激性潰瘍等併髮癥的髮生率.
목적 탐토조기장내영양연합생장격소재위중소상환자구치중적작용.방법 장35례엄중소상(30%～50%TBSA)환자,수궤분성장내영양조(EN조)화장외영양조(PN조),대비분석량조전백단백(PA)、종류배사인자(TNFα)、공복미량혈당수평、창면유합시간、평균주원시간、소상농독증발생솔、응격성궤양출혈화조기위장도불내수적발생솔.결과 EN평균주원시간교PN조축단.PN조출현소상농독증、응격성궤양화조기위장영양불내수발생솔교EN조위고(P<0.05).PN조급EN조PA균명현하강,단PN하강경위명현(P<0.05).PN조급EN조공복혈당수명현상승,단EN상승경위명현(P<0.05).EN조급PN조CRP、TNFα균명현승고,단이PN조승고위저(P<0.01).EN조공피구、식피구、심Ⅱ도창면교조축소(P<0.01).결론 조기장내영양연합생장격소능명현개선환자영양상황,강저농독증화응격성궤양등병발증적발생솔.
Objective To summarize the therapeutic effect of recombinant human growth hormone and early enteral nutrition in severely burned patients. Methods 35 cases were randomly divided into group EN and group PN.Group EN was treated with early enteral nutrition(EEN) and recombiant human growth hormone(rhGH) ,while group PN was given parenteral nutrition. The plasma levels of pre-albumin (PA), C-reactive protein (CRP) , tunmor necrosis factor α(TNFα) ,fasting blood glucose(FBG) were measured after burn injury. Comparision was made in length of hospital stay, wound healing time,incidence of burn sepsis, gastrointestinal stress ulcer bleeding and enteral nutrition intoleranc. Results Incidence of burn sepsis,gastrointestinal stress ulcer bleeding and enteral nutrition intoleranc in group EN were significantly lower than those of group PN(P ＜ 0.05). The serum levels of CRP、TNFα、FBG in group EN were significantly lower than those of group PN (P ＜ 0.05). The serum PA was decreased at all times in two periods and was markedly decreased in group EN(P ＜0.05). Length of hospital stay and the healing time of donor site, deep partial thickness burn wound, skin transplantion area were significantly shortened in group EN compared with group PN. Conclusion Early enteral nutrition was beneficial for the improving of nutrition state of the burn patients,and the reduction of the incidence of burn sepsis and the hospitalization time.
