烧伤后的代谢与内分泌考量

Metabolic and Endocrine Considerations After Burn Injury.

作者信息

Williams Felicia N, Herndon David N

机构信息

Department of Surgery, North Carolina Jaycee Burn Center, University of North Carolina, Chapel Hill, 3007D Burnett Womack Building, CB 7206, Chapel Hill, NC 27599-7206, USA.

Department of Surgery, Shriners Hospital of Children, University of Texas Medical Branch, 815 Market Street, Galveston, TX 77550, USA.

出版信息

Clin Plast Surg. 2017 Jul;44(3):541-553. doi: 10.1016/j.cps.2017.02.013. Epub 2017 Apr 21.

DOI:10.1016/j.cps.2017.02.013

PMID:28576243

Abstract

Severe burn injury is followed by a profound hypermetabolic response that persists up to 2 years after injury. It is mediated by up to 50-fold elevations in plasma catecholamines, cortisol, and glucagon that lead to whole-body catabolism, elevated resting energy expenditures, and multiorgan dysfunction. Modulation of the response by early excision and grafting of burn wounds, thermoregulation, control of infection, early and continuous enteral nutrition, and pharmacologic treatments aimed at mitigating physiologic derangements have markedly decreased morbidity.

摘要

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2年。它由血浆儿茶酚胺、皮质醇和胰高血糖素升高多达50倍介导，导致全身分解代谢、静息能量消耗增加和多器官功能障碍。通过早期切除和移植烧伤创面、体温调节、控制感染、早期和持续肠内营养以及旨在减轻生理紊乱的药物治疗来调节这种反应，已显著降低了发病率。