重度烧伤患者不同阶段营养支持效果探讨  

Analysis of the effects of nutritional support in the patients with severe burn at different stages

作　　者：温裕庆[1] 李荣兴[1] 简荣汉[2] 

机构地区：[1]福建医科大学附属龙岩第一医院烧伤整形医疗美容科,福建龙岩364000 [2]福建医科大学附属龙岩第一医院临床营养科,福建龙岩364000

出　　处：《中国现代医生》2016年第27期98-101,共4页China Modern Doctor

摘　　要：目的 对重度烧伤患者在不同阶段进行营养支持治疗的效果进行系统分析,为烧伤患者临床治疗提供指导。方法 将2013年2月-2016年2月我院收治的80例重度烧伤患者作为此次研究对象,本组患者在对症治疗同时,在休克期、感染期及康复期三个不同阶段进行针对性营养支持治疗,分析和总结本组患者的临床治疗效果。结果本组80例患者,通过治疗后,均得到良好愈合,未出现死亡病例;65例（81.3%）患者在连续治疗4-7周之后,体重恢复至正常水平,15例（18.7%）患者体重丢失在10%以下;患者的血蛋白水平和免疫功能恢复至正常水平,Ⅱ度烧伤面愈合时间为（12.0±2.4）d;深Ⅱ度烧伤面愈合时间为（20.8±2.5）d;Ⅲ度烧伤面愈合时间为（42.4±6.5）d。在营养治疗后,患者的免疫球蛋白、淋巴细胞计数明显提高,感染、康复阶段要显著高于治疗前、休克阶段（P〈0.05）,且感染、康复阶段比较差异有统计学意义（P〈0.05）。结论 对重度烧伤患者,在积极对症治疗同时,根据治疗阶段给予相应的营养支持治疗,能有效满足患者营养需要,强化机体免疫力,控制和减少并发症,降低病死率,临床意义重大。Objective To analyze the effects of nutritional support therapy in severe burn patients at different stages, and to provide guidance for clinical treatment of burn patients. Methods A total of 80 patients with severe burns treated in our hospital from February 2013 to February 2016 were selected as the research subjects. This group of patients were given the symptomatic treatment. At the same time, targeted nutritional support treatment was given at three different stages of shock, infection and rehabilitation. Clinical curative effects were analyzed and summarized in this group of patients. Results Good healing was observed in 80 patients in this group after the treatment, with no deaths; The body weight of 65 （81.3%） patients was observed to return to the normal levels after 4 to 7 weeks of continuous treatment, and the weight loss of 15 （18.7%） patients was less than 10%; the blood protein level and immune function of the patients were resumed to the normal level, and the healing time of degree Ⅱ burn surface was （12.0±2.4） d; the healing time of degree Ⅱ deep burn surface was （20.8±2.5） d; the degree Ⅲ healing time surface was （42.4±6.5） d. In nutrition therapy, immune globulin and lymphocyte count of the patients were significantly improved, infection rehabilitation stage was significantly higher than that of treatment before and shock stage （P〈0.05）, and the difference of infection and rehabilitation phase was statistically significant （P〈0.05）. Conclusion In patients with severe burns, at the same time of actively receiving symptomatic treatment, they should be given appropriate nutrition support according to the treatment phase, and this is able to meet the nutritional needs of the patients, strengthen immunity, control and reduce the complications and reduce the mortality, which is of great clinical significance.

关 键 词：重度烧伤 营养治疗 蛋白质代谢 免疫功能 

分 类 号：R644[医药卫生—外科学]