摘要
目的 观察早期肠内营养对烧伤高代谢反应的调节作用。方法 通过 30例烧伤患者用间接测热法监测静息能量消耗 (REE) ,监测血浆激素、脂类调节因子、细胞因子水平 ,并结合临床疗效和氮平衡变化来评价早期肠内营养的作用。结果 早期肠内营养 (EEN)组较延迟肠内营养 (DEN)组REE显著下降 (P <0 0 5～ 0 0 1) ,升高的时间缩短 (P <0 0 5 ) ;EEN组非蛋白呼吸商 (NPRQ)较DEN组更接近生理状态 ,负氮平衡时间缩短。伤后第 4天EEN组血浆去甲肾上腺素 (NE)、胰高糖素(GLUCAGON)、前列腺素E2 (PGE2 )、血栓素B2 (TXB2 )、低于DEN组 (P <0 0 5 ) ;伤后 8～ 12d肿瘤坏死因子α(TNF α)、白细胞介素 6 (IL 6 )显著低于DEN组 (P <0 0 5～ 0 0 1) ,胰岛素水平呈相反变化。
Objective This study was to explore the regulative effect of early enteral nutrition(EEN) on hypermetabolic response in patients suffering from burn.[WT5”HZ]Methods[WT5”BZ] Thirty burned patients with the average burn area of 49 90% (TBSA) were randomly divided into two groups:EEN( n =14),and delayed enteral nutrition(DEN)( n =16).Resting energy expenditure(REE),and non protein respiratory quotient(NPRQ) were measured every day.We worked out the plan of enteral nutrition.The patients were observed for 10 14 days.On postburn days(PBD) 0,4,8,12,we tested for the plasma levels of catecholamine(CA),insulin,glucagon,PGE 2,TXB 2,TNF α and IL 6.The nitrogen balance was calculated.Results In EEN group REE was much lower than that in DEN group( P <0 05),the NPRQ was close to normal levels.On PBD 4,the plasma levels of noradrenaline,dopamine,glucagon,PGE 2,TXB 2 in EEN were lower than that in DEN.On PBD 8,the serum levels of TNF α and IL 6 were lower in EEN than in DEN.The insulin level in EEN was higher than that in DEN.On PBD 12 ,the degree and duration of negative nitrogen balance were significantly different between the two groups.Conclusion EEN for severe burned patients had important regulative effect on the hypermetabolism.
出处
《中华普通外科杂志》
CSCD
北大核心
2001年第2期113-115,共3页
Chinese Journal of General Surgery
