CAJ | 학술논문

目的：探讨瑞代复合谷氨酰胺对大面积烧伤患者应激性高血糖及预后的影响。方法选择2013年1月至2015年2月在医院烧伤科住院的大面积烧伤患者44例，随机分为对照组和观察组，各22例。两组患者入院后均进行常规外科治疗，均留置鼻饲管行肠内营养，对照组采用单纯瑞代行肠内营养支持，观察组在瑞代中加入谷氨酰胺颗粒，疗程均为2周。结果治疗前两组患者的空腹血糖( FPG )、胰岛素抵抗指数( HOMA－IR )无明显差异（ P＞0.05），治疗1周及治疗后均有所改善，且观察组改善情况显著优于对照组（ P＜0.05）。治疗前两组患者补体C3及C4、C反应蛋白水平无明显差异，治疗后均降低，且观察组降低幅度大于对照组（ P＜0.05）。两组不良反应均较轻，发生率差异无统计学意义（ P＞0.05）。结论瑞代复合谷氨酰胺用于大面积烧伤患者，可有效改善患者FPG，HOMA－IR及降低身体应激状态指标，且无明显不良反应发生，值得临床推广。
목적：탐토서대복합곡안선알대대면적소상환자응격성고혈당급예후적영향。방법선택2013년1월지2015년2월재의원소상과주원적대면적소상환자44례，수궤분위대조조화관찰조，각22례。량조환자입원후균진행상규외과치료，균류치비사관행장내영양，대조조채용단순서대행장내영양지지，관찰조재서대중가입곡안선알과립，료정균위2주。결과치료전량조환자적공복혈당( FPG )、이도소저항지수( HOMA－IR )무명현차이（ P＞0.05），치료1주급치료후균유소개선，차관찰조개선정황현저우우대조조（ P＜0.05）。치료전량조환자보체C3급C4、C반응단백수평무명현차이，치료후균강저，차관찰조강저폭도대우대조조（ P＜0.05）。량조불량반응균교경，발생솔차이무통계학의의（ P＞0.05）。결론서대복합곡안선알용우대면적소상환자，가유효개선환자FPG，HOMA－IR급강저신체응격상태지표，차무명현불량반응발생，치득림상추엄。
Objective To investigate the influence on stress hyPerglycemia and Progrosis of massive area burn injury Patients treated by enteral nutritional emulsion ( TPF-D ) and glutamyl comPound. Methods 44 Patients from January 2013 to February 2015 large area burns in the hosPital were selected and randomly divided into the control grouP and observation grouP, 22 cases in each grouP. Two grouPs of Patients received conventional surgical treatment,on this basis all Patients were given nasogastric tube for enter-al nutrition, the control grouP were given simPle enteral nutrition,the observation grouP added glutamyl comPound. The treatment course was two weeks. Results Before treatment,the fasting Plasma glucose and insulin resistance index had no significant difference between the two grouPs( P > 0. 05),a week after treatment and had both imProved after 1 week of treatment,with the observation grouP imProned more than the control grouP ( P < 0. 05 );before treatment,the Physical stress indicator i. e. ,the reaction C3,C4,C-reac-tive Protein in both grouPs was no significant difference,and they all deereased;after treatment,with the observation grouP decreased more than the control grouP ( P < 0. 05 ) . The adverse reactions were mild in the two grouPs,with no statistically significant difference ( P > 0. 05 ) . Conclusion TPF-D and ghctanyl comPound in treating severe burn Patients can effectively imProve fasting Plasma glucose levels,insulin resistance index and reduce body stress indicators C3,C4,C-reactive Protein,has no significant adverse reac-tions,and is worthy of clinical Promotion.