摘要
目的:前瞻性观察两种营养支持途径对严重烧伤病人代谢的影响。 方法:临床烧伤病人19 例,随机分为早期肠道营养组(EN)和胃肠外营养组(PN)。有严重吸入伤、休克、消化道出血、明显腹泻及腹部疾患者不列入本研究。除行常规抗休克等处理外,EN 组伤后第1 天即口服或经鼻饲管注入奥力康,PN 组从静脉补充氨基酸、脂肪乳剂和葡萄糖等,两组热量和氮摄入基本相等。连续2 周观察24 h 尿氮、静息能量消耗(REE)、血浆皮质醇、胰高血糖素、胰岛素、血清TNF。 结果:早期肠道营养明显降低严重烧伤高代谢,24 h 尿氮排出在伤后11天后PN 组明显高于EN组,伤后第4、8 天PN 组REE明显高于EN组。REE的降低与分解代谢激素和炎症介质的降低有关。 结论:严重烧伤后早期肠道营养代谢调理作用优于肠外营养。
Objectives:This prospective study was desrgued to appraise the clinical effects of two nutrition routes at the initial stage of severe burn patients. Methods:19 cases were collected and divided randomly into early enteral nutrition group(EN) and parenteral nutrition group(PN).The patients complicated by inhalation injury,shock,stress ulcer,diarrhea and intestine disease were excluded.These two groups of patients were all treated as routine resuscitation scheme.Aolikong a kind of enteral nutrient was supplemented by oral or nose duodenum tube feeding within first 24 h in EN group,and amino acid,fat emulsion and glucose were supplemented by parenteral route in PN group.Calorie and nitrogen supplied were similar between EN and PN group.The investigation of 24 h urine nitrogen,REE,cortisol,glucagon,insulin and TNF lasted two weeks. Results:The early enteral feeding after burn injury was more effective to reduce the hypermetabolism response.The average of total urine nitrogen on PBD11,12,13,14 in EN were significantly lower than those of PN,REE on PBE4,8 in PN were significantly higher than that of EN.There are positive correlation between REE and glucagon or TNF. Conclusions:Early enteral nutrition is superior to parenteral nutrition in metabolism support at early stage of burn injury.
出处
《肠外与肠内营养》
CAS
2000年第1期19-22,共4页
Parenteral & Enteral Nutrition
关键词
烧伤
肠道营养
肠外营养
代谢
Burns,Clinical study
Enteral nutrition
Parenteral nutrition
