肠外营养治疗破伤风19例临床观察

Clinical observation of PN in the treatment of tetanus:report of 19 cases

应用PN治疗19例破伤风患者,1例死于冠心病,18例14～20天痊愈出院,病死率5.26％,且无需做气管切开和鼻饲,也无并发症。而以1989年以前的23例破伤风患者作对照组,死亡6例,死亡率26.08％,气管切开7例,鼻饲8例。英脱利匹(Intralipid)除供能外,还能治疗和预防必需脂肪酸缺乏,减少CO_2的形成,降低呼吸商以减轻呼吸负担,预防呼吸衰竭的作用。氨基酸供给体内的氮源,纠正低蛋白血症,防止肺水肿。所有药物均可从外周静脉输入,不需要气管切开与鼻饲饮食,减少对患者的不良刺激,又便于护理。

Using PN in the treatment of tetanus show better curative effect. In addition to supplying energy Intralipid can cure and prevent the deficiency of necessary fatty acid, it can also reduce the formation of carbon dioxide and respiratory quotient. Which can deduct the burden of respiration and prevent respiratory failure. As well as supplying nitroge requirement to humon body, amine acids can correct hypoalbuminemia and prevent pneumonedema. All medicines are infused via peripheral intravein instead of tracheotomy and nasal feeding, which is convient of nursing and deduct the stimulus to the patients. The clinical results of 19 patients indicate that PN has the features of improving immunological function, decraesing the number of complication and increasing the curative possibility. It will be one of the effective method to treat various surgical diseases.