危重烧伤患者74例的营养支持和免疫调节治疗体会

Experience on treatment of 74 severe burn cases with nutritional support and immune adjustment

目的探讨危重烧伤患者营养支持和免疫调节的治疗方法和效果。方法回顾性分析74例Ⅱ度～Ⅲ度烧伤总面积50%～98%TBSA烧伤患者术后营养支持及免疫调节治疗情况。依据入院后是否予以营养支持及免疫调节治疗分为治疗组和对照组,治疗组36例,伤后48h后及手术后3d开始实施营养支持和免疫调节治疗,包括适当比例的糖、脂肪和氨基酸;免疫调节的药物包括重组人生长激素、胰岛素、胸腺五肽以及谷氨酰胺等抗炎免疫营养素,20d为一个疗程。对照组38例按临床常规治疗。结果治疗20d时,治疗组治疗前后血红蛋白、血浆白蛋白及血钾升高幅度大于对照组,差异具有统计学意义(P<0.01),谷丙转氨酶降低的程度大于对照组(P<0.01)。两组平均治愈时间治疗组(36.23±3.16)d较对照组(43.31±8.54)d明显缩短(P<0.01)。结论对危重烧伤患者实施营养支持和免疫调节治疗,可缩短治疗时间,有利于危重烧伤患者的治疗康复。

Objective To observe the effect of nutritional support and immune regulation therapy in patients with severe burns. Methods Seventy-four cases with severe burns from June 2001 to June 2011 were enrolled for the research,and were randomly divided into the treatment group and the control group. The treatment group（n=36）were given nutritional support and immune regulation medicines after shock phase and three days after surgery and lasted 20 days, while the control group （n=38） were given routine treatment. Results The increased value of hemoglobin, serum albumin and serum potassium and the decreased value of alanine aminotransferase level in the treatment were significantly greater than in the control group （all P0.01）, while the average healing time of the treatment group was significantly shorter than that of the control group （P0.01）. Conclusion This treatment plan is very beneficial for treatment and rehabilitation of patients with severe burns.