小儿重度烧伤早期胃肠道营养302例临床分析

A clinical analysis of early enteral nutrition in 302 severely burned children

目的 :回顾性分析 3 0 2例小儿严重烧伤后 ,早期胃肠道营养对防止胃肠道大出血的临床经验。 方法 :分析 1980年至 2 0 0 1年 10月收治的 5 73例小儿烧伤中 ,3 0 2例为严重烧伤 ,在积极抗休克治疗的同时不禁食 ,并指导亲属施行早期胃肠道营养 ,同时观察胃肠道并发症的情况。 结果 :3 0 2例严重烧伤患儿中 ,2 5例早期有明显休克 ,均平稳度过休克期。除 2例并发急性胃扩张、腹泻及排柏油样便外 ,无一例并发胃肠道大出血。本组 3 0 2例中死亡 8例 ( 2 .6% ) ,烧伤总面积均 >5 0 % ,除 1例死于化学性烧伤中毒外 ,其余 7例均死于后期严重感染或MOF。 结论 :在早期积极有效的抗休克治疗基础上 ,及早进行口服胃肠道营养治疗 ,并充分发挥患儿亲属的作用 ,对预防胃肠道大出血有积极作用 。

Objectives:To analyze retrospectively the result of early enteral nutrition in 302 severely burned children and discuss its role in the prevention of massive gastrointestinal bleeding after burn. Methods: Early enteral feeding were delivered by children's parents under the help of doctors and nurses while anti shock therapy proceed. Gastro intestinal complications were observed at same time. Results: All 302 cases recovered, only 25 cases developed shock symptoms, and 2 cases developed gastric distension, diarrhea and tarry stool, no one developed massive gastro intestinal bleeding, 8 cases died( 2.67 %), 1 died of chemical burn toxin, and 7 died of severe infection and MOF. Conclusions: Our 20 years' experiences convinced that early enteral feeding delivered by children's parents under the help of doctors and nurses may prevent gastro intestinal bleeding and other complications, it is also a psychotherapy for severely burned children, but anti shock treatment must be carried out at the same time.