[1]陆芹芹,黄兰芳,齐 燕.重度烧伤病人营养治疗的研究进展[J].肠外与肠内营养杂志,2019,(04):245-249.[doi:DOI : 10.16151/j.1007-810x.2019.04.012]
 LU Qin-qin,HUANG Lan-fang,QI Yan.Research progress of nutritional therapy for severe burn patients[J].PARENTERAL & ENTERAL NUTRITION,2019,(04):245-249.[doi:DOI : 10.16151/j.1007-810x.2019.04.012]
点击复制

重度烧伤病人营养治疗的研究进展
分享到:

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2019年04期
页码:
245-249
栏目:
综述
出版日期:
2019-07-10

文章信息/Info

Title:
Research progress of nutritional therapy for severe burn patients
作者:
陆芹芹黄兰芳齐 燕
浙江省绍兴第二医院ICU,浙江绍兴 312000
Author(s):
LU Qin-qin HUANG Lan-fang QI Yan
ICU, the Second Hospital of Shaoxing, Shaoxing 312000, Zhejiang, China
关键词:
重度烧伤 营养治疗 肠内营养 肠外营养
Keywords:
Severe burns Nutrition th erapy Enteral nutrition Parenteral nutrition
分类号:
R459.3
DOI:
DOI : 10.16151/j.1007-810x.2019.04.012
文献标志码:
A
摘要:
随着对烧伤认识的深入,从营养支持到营养治疗的理念转变体现了营养在烧伤病人的治疗中起着举足轻重的作用。本文结合烧伤病人的代谢特点,对营养治疗研究进展进行综述,包括营养治疗的能量需求计算,碳水化合物、蛋白质、脂肪、微量元素等需求量及注意事项,尤其是肠内营养(EN)和肠外营养(PN)对烧伤病人的利弊。
Abstract:
With the deep understanding of burns, the transition from nutrition support to nutritional therapy reflects the role of nutrition in the treatment of burn patients. This article reviews the progress of nutritional therapy research in combination with the metabolic characteristics of burn patients, including the energy demand calculation of nutrition therapy, the demand for carbohydrates, protein, fat, trace elements and precautions, especially the advantages and disadvantages of enteral nutrition(EN) and parenteral nutrition(PN) on burn patients.

参考文献/References:


[1] 中华医学会 . 临床诊疗指南 . 肠外肠内营养学分册 . 北京:人民卫生出版社, 2008:62-65.
[2] 彭 曦, 汪仕良 . 烧伤临床营养新理念:从营养支持到营养治疗 . 中华烧伤杂志, 2011, 27(5):329-331.
[3] Herndon DN. Total burn care. Philadelphia: Saunders Elsevier,2007:398-419.
[4] Wilmore DW, Mason AD Jr , Johnson DW, et al. Effect of ambient temperature on heat production and heat loss in burn patients. J App Physiol, 1975, 38(4):593-597.
[5] 曹丽萍, 邓诗琳, 梁建伟, 等 . 烧伤后能量代谢变化规律的研究 . 肠外与肠内营养, 2000, 7(4): 252.
[6] Casaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med,2011,365 (6):506-517.
[7] Academy of Nutrition and Dietetics Nutrition Care Manual. Burns Nutrition Prescription. 2011, 2016-05-26.
[8] Davis KA, Kinn T, Esposito TJ, et al. Nutritional gain versus financial gain: The role of metabolic carts in the surgical ICU. J Trauma, 2006, 61(6):1436-1440.
[9] Cresci G, Gottschlich M, Mayes T, et al. Trauma, surgery, and burns. The A.S.P.E.N. nutrition support core curriculum: a casebased approach – the adult patient. Silver Springs (MD): A.S.P.E.N, 2007:455–472.
[10] 杨 丽, 孟宪熙, 唐寒芬, 等 . 重度烧伤患者肠内营养护理规范的循证实践 . 中华烧伤杂志, 2017, 33(1):53-55.
[11] 秦启红, 钮丹叶, 刘 军, 等 . 代谢车在重度烧伤病人能量代谢测定中的应用 . 肠外与肠内营养,2016,23(6):332-335.
[12] Taylor BE, McClave SA, Martindale RG, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine(SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med,2016,44(2):390-438.
[13] 彭 曦 . 烧伤高代谢机制的再认识及调控策略 . 中华烧伤杂志, 2013, 29(2):139-143.
[14] Gore DC , Rinehart A , Asimakis G . Temporal changes in cellular energy following burn injury. Burns, 2005, 31(8):998-1002.
[15] Mehta NM, Skillman HE, Irving SY, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr, 2017, 41(5):706-742.
[16] Wolfe RR, Goodenough RD, Wolfe MH. Isotopic approaches to the estimation of protein requirements in burn patients. Adv Shock Res, 1983, 9:81-98.
[17] Berger MM. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo controlled trial. Am J Clin Nutr 1998, 68(2):365-371.
[18] Rousseau AF, Losser MR, Ichai C, et al. ESPEN endorsed recommendations: nutritional therapy in major burns. Clin Nutr,2013, 32(4):497-502.
[19] 胡 森, 车晋伟, 包呈梅, 等 . 维生素 C对烧伤休克犬口服补液时内脏脂质过氧化损伤的影响 . 中华医学杂志, 2009, 89(33):2364-2367.
[20] Tanaka H, Matsuda T, Miyagantani Y, et al. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study.Arch Surg, 2000, 135(3):326-331.
[21] 中国医师协会烧伤医师分会《烧伤感染诊治指南》编辑委 . 烧伤感染的诊断标准与治疗指南(2012版). 中华烧伤杂志, 2012, 28(6):401-403.
[22] Garrel D, Patenaude J, Nedelec B, et al. Decreased mortality and infectious morbidity in adult burn patients given enteral glutamine supplements: a prospective, controlled, randomized clinical trial. Crit Care Med, 2003,31(10):2444-2449.
[23] 欧阳容兰, 黄书润, 刘江涛, 等 .谷氨酰胺对肠内免疫治疗重度烧伤患者免疫功能紊乱及营养失衡的影响 .解放军医药杂志,2016,28(10):100-103.
[24] Chen QH , Yang Y , He HL , et al. The effect of glutamine therapy on outcomes in critically ill patients: a meta-analysis of randomized controlled trials. Critical Care, 2014, 18(1):R8.
[25] Bradshaw C , Goodman I , Rosenberg R , et al. Implementation of an Inpatient Pediatric Sepsis Identification Pathway. Pediatrics, 2016, 137(3):e20144082.
[26] Holder AL , Gupta N , Lulaj E , et al. Predictors of early progression to severe sepsis or shock among emergency department patients with nonsevere sepsis. Int J Emerg Med, 2016, 9(1):10.
[27] 葛章伟, 蔡 晨, 徐庆连, 等 . ω-3多不饱和脂肪酸对严重烧伤大鼠肾组织及其炎性反应的影响 . 肠外与肠内营养, 2014, 21 (4):233-235.
[28] 蔡 晨, 夏正国, 徐庆连, 等 . ω-3多不饱和脂肪酸对严重烧伤大鼠早期肠黏膜损伤的影响及其机制 . 中华烧伤杂志, 2017, 33(8):476-480.
[29] 夏正国, 徐庆连, 蔡 晨, 等 . ω-3多不饱和脂肪酸对严重烧伤大鼠心肌损伤保护作用的实验研究 . 安徽医学, 2012, 33(5):515-519.
[30] 缪玉兰, 夏照帆, 付晋凤 . 严重烧伤后胰岛素抵抗的发生及防治进展 . 中华烧伤杂志, 2008, 24(3):234-238.
[31] Nusbaum NJ. Intensive insulin therapy in critically ill patients. N Engl J Med, 2002,346(20):1586-1588.
[32] 王沈华, 张 茂 . 危重症患者静脉使用胰岛素控制高血糖指南 . 中华急诊医学杂志, 2013, 22(8):838-839.
[33] Chiarelli A, Enzi G, Casadei A, et al. Very early nutrition supplementation in burned patients. Am J Clin Nutr, 1990, 51(6):1035-1039.
[34] Peng YZ, Yuan ZQ, Xiao GX. Effects of early enteral feeding on the prevention of enterogenic infection in severely burned patients. Burns, 2001,27(2):145-149.
[35] 解伟光 . 烧伤营养治疗新概念——零禁食 . 中华烧伤杂志,2006, 22(4):312.
[36] 周继涛, 张艳红, 谢向群, 等 .“零禁食”对重症烧伤患者近期疗效的影响 . 中华全科医学, 2013, 11(4):639-640.
[37] 彭 曦, 尤忠义, 王 裴, 等 . 不同营养支持途径对烧伤后肠源性高代谢的影响 . 肠外与肠内营养, 2005, 12(3):159-161.
[38] Casaer MP, Mesotten D, Hermans G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med, 2011,365(6):506-517.
[39] van Nieuwenhoven CA, Vandenbroucke-Grauls C, van Tiel FH,et al. Feasibility and effects of the semirecumbent position to prevent ventilator-associated pneumonia: a randomized study.Crit Care Med, 2006,34(2):396-402.
[40] Li EC, Esterly JS, Pohl S, et al. Drug-induced QTinterval prolongation: considerations for clinicians. Pharmacotherapy, 2010,30(7):684-701.
[41] Lam NN, Tien NG, Khoa CM. Early enteral feeding for burned patients–an effective method which should be encouraged in developing countries. Burns 2008;34(2):192-196

相似文献/References:

[1]蔡常洁,李姝翮.急性胰腺炎的营养治疗策略:“肠道唤醒”比“胰腺休息”更重要[J].肠外与肠内营养杂志,2019,(06):326.[doi:10.16151/j.1007-810x.2019.06.003]
[2]吴秀文.新型冠状病毒肺炎营养治疗的研究进展[J].肠外与肠内营养杂志,2020,(03):133.[doi:10.16151/j.1007-810x.2020.03.002]
[3]夏露露,闫洁,黄金狮.1例努南综合征并发乳糜胸病儿的营养治疗[J].肠外与肠内营养杂志,2020,(03):190.[doi:DOI : 10.16151/j.1007-810x.2020.03.014]
[4]彭 曦.重视谷氨酰胺在烧伤临床的规范应用[J].肠外与肠内营养杂志,2021,(01):1.[doi:10.16151/j.1007-810x.2021.01.001]
[5]闫 彬,庞国勋.新型冠状病毒肺炎预防与营养治疗方案汇总分析[J].肠外与肠内营养杂志,2021,(01):10.[doi:10.16151/j.1007-810x.2021.01.003]
 YAN Bin,PANG Guo-xun.Systematic review of prevention and nutritional treatment regimens for COVID-19[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):10.[doi:10.16151/j.1007-810x.2021.01.003]
[6]汪新有,翁延宏,陈伟.胃癌根治术后早期肠内营养的应用探讨[J].肠外与肠内营养杂志,2021,(04):216.[doi:10.16151/j.1007-810x.2021.04.006]
 WANG Xin-you,WENG Yan-hong,CHEN Wei.Application of early enteral nutrition after radical resection of gastric cancer[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):216.[doi:10.16151/j.1007-810x.2021.04.006]
[7]姚德贞,王丽杰.PICU危重病儿营养管理现状单中心调查[J].肠外与肠内营养杂志,2022,(02):69.[doi:10.16151/j.1007-810x.2022.02.002]
 YAO De-zhen,WANG Li-jie.The nutritional management survey in critically ill children in PICU: a single center study[J].PARENTERAL & ENTERAL NUTRITION,2022,(04):69.[doi:10.16151/j.1007-810x.2022.02.002]
[8]付 娟,谢卫国,褚志刚,等.重症烧伤病人的营养治疗及临床指标分析[J].肠外与肠内营养杂志,2022,(06):351.[doi:10.16151/j.1007-810x.2022.06.006]
 FU Juan,XIE Wei-guo,CHU Zhi-gang,et al.Nutritional therapy and clinical index analysis of severe burn patients[J].PARENTERAL & ENTERAL NUTRITION,2022,(04):351.[doi:10.16151/j.1007-810x.2022.06.006]
[9]曹楚雄,朱文艺,白 倩,等.冠心病PCI病人围手术期营养治疗效果及临床结局的评价研究[J].肠外与肠内营养杂志,2023,(02):75.[doi:10.16151/j.1007-810x.2023.02.003]
 CAO Chu-xiong,ZHU wen-yi,BAI Qian,et al.Evaluation of perioperative nutritional therapy effect and clinical outcome of PCI patients with coronary heart disease[J].PARENTERAL & ENTERAL NUTRITION,2023,(04):75.[doi:10.16151/j.1007-810x.2023.02.003]
[10]邱进寿,吴雅云,林进皇,等.1例鸟氨酸氨甲酰转移酶缺乏症的营养治疗观察[J].肠外与肠内营养杂志,2023,(06):381.[doi:DOI : 10.16151/j.1007-810x.2023.06.011]

备注/Memo

备注/Memo:
作者简介 :陆芹芹,医师,医学硕士研究生,从事重症医学专业。E-mail:527020985@qq.com
更新日期/Last Update: 1900-01-01