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压疮与营养

Pressure Ulcer and Nutrition.

作者信息

Saghaleini Seied Hadi, Dehghan Kasra, Shadvar Kamran, Sanaie Sarvin, Mahmoodpoor Ata, Ostadi Zohreh

机构信息

Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

出版信息

Indian J Crit Care Med. 2018 Apr;22(4):283-289. doi: 10.4103/ijccm.IJCCM_277_17.

Abstract

Pressure ulcers can diminish global life quality, contribute to rapid mortality in some patients and pose a significant cost to health-care organizations. Accordingly, their prevention and management are highly important. Nutritional deprivation and insufficient dietary intake are the key risk factors for the development of pressure ulcers and impaired wound healing. Unplanned weight loss is a major risk factor for malnutrition and pressure ulcer development. Suboptimal nutrition interferes with the function of the immune system, collagen synthesis, and tensile strength. No laboratory test can exactly define an individual's nutritional status. Although serum albumin, prealbumin, transferrin, and retinol-binding protein as well as anthropometric measures such as height, weight, and body mass index and the other laboratory values may be suitable to establish the overall prognosis, still they might not well represent the nutritional status. Although the ideal nutrient intake to encourage wound healing is unknown, increased needs for energy, protein, zinc, and Vitamins A, C, and E and also amino acids such as arginine and glutamine have been documented. Hydration plays a vital role in the preservation and repair of skin integrity. Dehydration disturbs cell metabolism and wound healing. Adequate fluid intake is necessary to support the blood flow to wounded tissues and to prevent additional breakdown of the skin. The main aim of the present article is to review the current evidence related to hydration and nutrition for bedsore prevention and management in adults.

摘要

压疮会降低整体生活质量,导致部分患者快速死亡,并给医疗机构带来巨大成本。因此,压疮的预防和管理至关重要。营养缺乏和饮食摄入不足是压疮形成及伤口愈合受损的关键危险因素。非计划体重减轻是营养不良和压疮形成的主要危险因素。营养状况欠佳会干扰免疫系统功能、胶原蛋白合成及拉伸强度。没有任何实验室检测能够准确界定个体的营养状况。尽管血清白蛋白、前白蛋白、转铁蛋白、视黄醇结合蛋白以及诸如身高、体重、体重指数等人体测量指标和其他实验室值可能有助于确定总体预后,但它们可能无法很好地反映营养状况。虽然促进伤口愈合的理想营养素摄入量尚不清楚,但已有文献记载能量、蛋白质、锌、维生素A、C和E以及精氨酸和谷氨酰胺等氨基酸的需求增加。水合作用在维持和修复皮肤完整性方面起着至关重要的作用。脱水会干扰细胞代谢和伤口愈合。充足的液体摄入对于支持受伤组织的血液流动和防止皮肤进一步破损是必要的。本文的主要目的是综述目前有关水合作用和营养在成人压疮预防和管理方面的证据。

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