Department of Surgery, Shriners Hospitals for Children-Galveston and the University of Texas Medical Branch, Galveston, Texas.
JPEN J Parenter Enteral Nutr. 2013 Sep;37(5 Suppl):21S-9S. doi: 10.1177/0148607113496117.
The stress response to surgery, critical illness, trauma, and burns encompasses derangements of metabolic and physiological processes that induce perturbations in the inflammatory, acute phase, hormonal, and genomic responses. Hypermetabolism and hypercatabolism result, leading to muscle wasting, impaired immune function and wound healing, organ failure, and death. The surgery-induced stress response is largely similar to that triggered by traumatic injuries; the duration of the stress response, however, varies according to the severity of injury (surgical or traumatic). This spectrum of injuries and insults ranges from small lacerations to severe insults such as large poly-traumatic and burn injuries. Burn injuries provide an extreme model of trauma induced stress responses that can be used to study the long-term effects of a prolonged stress response. Although the stress response to acute trauma evolved to confer improved chances of survival following injury, in modern surgical practice the stress response can be detrimental.
手术、重症疾病、创伤和烧伤引起的应激反应包括代谢和生理过程的紊乱，这些紊乱会导致炎症、急性期、激素和基因组反应的波动。结果导致代谢亢进和分解代谢亢进，导致肌肉消耗、免疫功能受损和伤口愈合、器官衰竭和死亡。手术引起的应激反应与创伤引起的应激反应基本相似；然而，应激反应的持续时间取决于损伤的严重程度（手术或创伤）。这种损伤和损伤的范围从小的撕裂伤到严重的损伤，如大面积多发创伤和烧伤。烧伤提供了创伤引起的应激反应的极端模型，可用于研究长期应激反应的影响。尽管急性创伤引起的应激反应是为了在受伤后提高生存机会而进化的，但在现代外科实践中，应激反应可能是有害的。
