Williams Felicia N, Herndon David N, Jeschke Marc G
Department of Surgery, The University of Texas Medical Branch, Galveston, USA.
Clin Plast Surg. 2009 Oct;36(4):583-96. doi: 10.1016/j.cps.2009.05.001.
Severe burn injury is followed by a profound hypermetabolic response that persists up to 24 months after injury. It is mediated by up to 50-fold elevations in plasma catecholamines, cortisol, and inflammatory cells that lead to whole-body catabolism, elevated resting energy expenditures, and multiorgan dysfunction. All of these metabolic and physiologic derangements prevent full rehabilitation and acclimatization of burn survivors back into society. Modulation of the response by early excision and grafting of burn wounds, thermoregulation, early and continuous enteral feeding with high-protein high-carbohydrate feedings, and pharmacologic treatments have markedly decreased morbidity.
严重烧伤后会出现严重的高代谢反应，这种反应在受伤后可持续长达24个月。它是由血浆儿茶酚胺、皮质醇和炎症细胞升高多达50倍介导的，这些会导致全身分解代谢、静息能量消耗增加和多器官功能障碍。所有这些代谢和生理紊乱都阻碍了烧伤幸存者完全康复并重新融入社会。通过早期切除和移植烧伤创面、体温调节、早期持续肠内给予高蛋白高碳水化合物喂养以及药物治疗来调节这种反应，已显著降低了发病率。
