摘要
目的探讨早期肠内营养（EEN）在严重烧伤患者治疗中的价值。方法回顾性分析3家笔者单位2014年8—9月收治的共52例严重烧伤患者病历资料，根据肠内营养启动时间分为EEN组28例与非EEN组24例。在常规治疗基础上，EEN组患者于伤后3d内进行肠内营养，非EEN组患者于伤后3d后进行肠内营养。比较2组患者伤后1、2、3、4、5、6、7、14、21、28d肠内营养量／摄入总能量比值、肠外营养量／摄入总能量比值、摄入总能量／目标能量比值，伤后1、3、7、14、28d前白蛋白、血肌酐、血尿素氮、总胆红素、直接胆红素水平以及急性生理与慢性健康评估Ⅱ（APACHEⅡ）评分，伤后28d内首次手术时间、手术次数以及发生腹胀、腹泻、呕吐、误吸、导管堵塞、低血糖次数。对数据行χ^2检验、t检验、Wilcoxon秩和检验，并进行Bonferroni校正。结果（1）EEN组患者伤后1d肠外营养量／摄入总能量比值明显低于非EEN组（Z=2．078，P〈0．05），伤后2、3d肠内营养量／摄入总能量比值及摄入总能量／目标能量比值明显高于非EEN组（Z=5．766、6．404，t=4．907、6．378，P〈0．01），伤后4、5、6、7d摄入总能量／目标能量比值明显低于非EEN组（t=4．635、2．547、3．751、5．373，P〈0．05或P〈0．01）。EEN组患者伤后2、4、5、14、21、28d肠内营养量／摄入总能量比值明显高于组内肠外营养量／摄入总能量比值（Z=5．326、2．046、2．129、4．118、3．174、3．963，P〈0．05或P〈0．01）；非EEN组患者伤后1、2、3d肠内营养量／摄入总能量比值明显低于组内肠外营养量／摄入总能量比值（Z=2．591、2．591、3．293，P〈0．05或P〈0．01），伤后14、21、28d肠内营养量／摄入总能量比值明显高于组内肠外营养量／摄入总能量比值（Z=2．529、3．173、3．133，P〈0．05或P〈0．01）。（2）2组患者伤后1、3、7、14d前白蛋白水�
Objective To investigate the effects of early enteral nutrition （EEN） in the treatment of patients with severe burns. Methods Medical records of 52 patients with severe burns hospitalized in the three affiliations of authors from August to September in 2014 were retrospectively analyzed and divided into EEN group （ n = 28） and non-early enteral nutrition （NEEN） group （ n = 24） according to the initiation time of enteral nutrition. On the basis of routine treatment, enteral nutrition was given to patients in group EEN within post injury day （POD） 3, while enteral nutrition was given to patients in group NEEN after POD 3. The following items were compared between patients of the two groups, such as the ratio of enteral nutrition intake to total energy intake, the ratio of parenteral nutrition intake to total energy intake, the ratio of to- tal energy intake to energy target on POD 1, 2, 3, 4, 5, 6, 7, 14, 21, and 28, the levels of prealbumin, serum creatinine, blood urea nitrogen, total bilirubin, direct bilirubin, and Acute Physiology and Chronic Health EvaluationⅡ （APACHE Ⅱ） score on POD 1, 3, 7, 14, and 28, the first operation time, the number of operations, and the frequencies of abdominal distension, diarrhea, vomiting, aspiration, catheter blockage, and low blood sugar within POD 28. Data were processed with χ^2 test, t test, Wilcoxon rank sum test, and Bonferroni correction. Results （ 1 ） The ratio of parenteral nutrition intake to total energy intake of patients in group EEN on POD 1 was obviously lower than that in group NEEN （ Z = 2. 078, P 〈 0.05）. The ratio of enteral nutrition intake to total energy intake and the ratio of total energy intake to energy target of patients in group EEN on POD 2 and 3 were obviously higher than those in group NEEN （ Z = 5. 766, 6. 404, t = 4. 907, 6. 378, P 〈 0.01 ）. The ratio of total energy intake to energy target of patients in group EEN was obviously lower than that in group NEEN on POD 4, 5, 6, and7 （ t =4.635, 2. 547, 3
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2018年第1期40-46,共7页
Chinese Journal of Burns
基金
江苏省自然科学基金（BK20141175）
江苏省卫生厅科技项目（H201466）
江苏省医药卫生科技项目（Z201414）
关键词
烧伤
肠道营养
治疗结果
Burns
Enteral nutrition
Treatment outcome
