CAJ | 학술논문

目的探讨高能量密度营养乳剂的肠内营养对严重烧伤患者的临床疗效.方法将40例烧伤总面积31%～70%,Ⅲ度烧伤面积＞11%的重症烧伤患者随机分为对照组和试验组,每组20例.两组均自烧伤后第1天开始留置鼻胃管行肠内营养.试验组采用普通饮食喂养加高能量密度营养乳剂,对照组采用普通饮食喂养.分别于营养治疗前、烧伤后第1、3、7、10、14、21天检测患者的血红蛋白、血清白蛋白和总淋巴细胞计数.计算每日氮平衡,统计并发症发生率.结果烧伤后第14、21天,试验组血清白蛋白水平显著高于对照组(P＜0.05),两组的血红蛋白水平和总淋巴细胞计数的差异无统计学意义(P＞0.05).自烧伤后第10天起,试验组的氮平衡均显著高于对照组(P＜0.05).试验组腹胀、腹泻、恶心呕吐等并发症的发生率均低于对照组.结论高能量密度营养乳剂能改善严重烧伤患者的氮平衡,降低肠内营养并发症的发生率.
목적 탐토고능량밀도영양유제적장내영양대엄중소상환자적림상료효.방법 장40례소상총면적31%～70%,Ⅲ도소상면적＞11%적중증소상환자수궤분위대조조화시험조,매조20례.량조균자소상후제1천개시류치비위관행장내영양.시험조채용보통음식위양가고능량밀도영양유제,대조조채용보통음식위양.분별우영양치료전、소상후제1、3、7、10、14、21천검측환자적혈홍단백、혈청백단백화총림파세포계수.계산매일담평형,통계병발증발생솔.결과 소상후제14、21천,시험조혈청백단백수평현저고우대조조(P＜0.05),량조적혈홍단백수평화총림파세포계수적차이무통계학의의(P＞0.05).자소상후제10천기,시험조적담평형균현저고우대조조(P＜0.05).시험조복창、복사、악심구토등병발증적발생솔균저우대조조.결론 고능량밀도영양유제능개선엄중소상환자적담평형,강저장내영양병발증적발생솔.
Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g · kg±1 · d±1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor± ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera± tion but without significant difference [control group: (2. 24 ±0. 84) fig/ml, study group: (2. 32 ±0.92) μg/ml, normal value: (1.27 ±0.44) μg/ml]. On the post±operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31 ±1. 05) μg/ml] was significantly higher than that of control group [ (3. 04± 1. 01) μ/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with± out significant difference [ (33. 3 ±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.