摘要
五年来我所对烧伤代谢营养研究的主要工作:①建立了三个新的且较实用的供烧伤胃肠营养研究的动物模型;②应用间接测热法,对92例成人烧伤的静息能量消耗进行了检测和分析,并在此基础上提出了我国烧伤成人热卡需量公式:千卡/天=1000×体表面积米~2+25×烧伤面积%;③通过动物实验及临床前瞻性研究,发现氧自由基拮抗剂(SOD、CAT)、甲磺丁脲、谷氨酰胺以及四君子汤对烧伤后代谢营养均有调理作用,可降低分解代谢,减少负氮平衡,刺激胰岛素释放,改善葡萄糖利用,维持肠粘膜质量,维护、增强小肠等内脏功能;④研制了刺激性小,简便而经济的经鼻肠道营养管。一般6小时内即可经幽门进入十二指肠,有利于烧伤后早期肠道营养的开展。
This paper introduces the essential experiences concerning studies of burn metabolism and nutrition in our institute in the past five years.①Three new and practical animal models were developed for studying gastro-enteral nutrition in burns.②With indirect calorimetry,resting energy expenditure (REE) of 92 burn adult patients were measured and analyzed,and on the basis of which a new formula for calculating nutritional supplement in Chinese burn adults was proposed:kcal/day=1000×M^2 (body surface area) +25×%TBSA (total burn surface area).③Through experimental and clinical studies,it was found that antiouperoxide agents (such as SOD,CAT),tolbutamide,glutamine and Chinese herb decoction Sizunzituang all exhibited modulating effects on postburn metabo- lism and nutrition,e.g.decreasing catabolism,reducing negative nitrogen balance,stimu- lating secretion of insulin,enhancing tissue utilization of glucose,maintaining the mass of enteral mucosa and improving functions of viscerae.④A new,less irritating,simple and easy-to-introduce nasal-enteral nutrition tube was devised,which could pass through the pylorus easily into the d usually within this without using a stylet.It would be useful in the early postburn enteral nutrition supplementation.
