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[广泛化脓性软组织伤口外科患者蛋白质 - 能量缺乏参数的评估]

[Assessment of the parameters of protein-energy deficiency in surgical patients with extensive purulent soft tissue wounds].

作者信息

Shodiev I A, Sviridov S V, Ismailova Z Z, Kozlov V F, Bakushin V S, Smol'tsov E Iu

出版信息

Anesteziol Reanimatol. 2008 May-Jun(3):25-8.

Abstract

The paper considers criteria for evaluating postoperative protein-energy deficiency (PED) in surgical patients with extensive purulent soft tissue wounds (PSTW) of the extremities and torso. The authors have evaluated the clinical significance of somatometric indices (height (cm), weight (kg), arm circumference (cm), skinfold thickness above the triangularis, body mass index) and biochemical markers of PED (total protein (g/l), albumin (g/l), transferrin (g/l), absolute lymphocyte count (ALC). At the early stages of the disease (3-5 days after injury or infection), plasma transferrin concentrations and ALC significantly reduced, which is characteristic of moderate and severe PED. At the same time, the somatic protein pool was virtually unchanged, as shown by the anthropometric characteristics. The authors conclude that in all the patients with PED, primary PED is associated with the visceral protein pool changes by the type of kwashiorkor (malignant malnutrition). Early supplementary formula feeding is required and advisable.

摘要

本文探讨了评估患有四肢和躯干广泛化脓性软组织伤口(PSTW)的外科手术患者术后蛋白质 - 能量缺乏(PED)的标准。作者评估了人体测量指标(身高(厘米)、体重(千克)、臂围(厘米)、三角肌上方皮褶厚度、体重指数)以及PED的生化标志物(总蛋白(克/升)、白蛋白(克/升)、转铁蛋白(克/升)、绝对淋巴细胞计数(ALC))的临床意义。在疾病早期(受伤或感染后3 - 5天),血浆转铁蛋白浓度和ALC显著降低,这是中度和重度PED的特征。与此同时,人体测量特征显示体细胞蛋白池基本未变。作者得出结论,在所有患有PED的患者中,原发性PED与夸希奥科病(恶性营养不良)类型的内脏蛋白池变化有关。早期补充配方喂养是必要且可取的。

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