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肥胖对重度烧伤患者治疗及预后的影响

The Influence of Obesity on Treatment and Outcome of Severely Burned Patients.

作者信息

Tapking Christian, Houschyar Khosrow S, Rontoyanni Victoria G, Hundeshagen Gabriel, Kowalewski Karl-Friedrich, Hirche Christoph, Popp Daniel, Wolf Steven E, Herndon David N, Branski Ludwik K

机构信息

Department of Surgery, University of Texas Medical Branch, Galveston.

Shriners Hospitals for Children, Galveston, Texas.

出版信息

J Burn Care Res. 2019 Oct 16;40(6):996-1008. doi: 10.1093/jbcr/irz115.

Abstract

Obesity and the related medical, social, and economic impacts are relevant multifactorial and chronic conditions that also have a meaningful impact on outcomes following a severe injury, including burns. In addition to burn-specific difficulties, such as adequate hypermetabolic response, fluid resuscitation, and early wound coverage, obese patients also present with common comorbidities, such as arterial hypertension, diabetes mellitus, or nonalcoholic fatty liver disease. In addition, the pathophysiologic response to severe burns can be enhanced. Besides the increased morbidity and mortality compared to burn patients with normal weight, obese patients present a challenge in fluid resuscitation, perioperative management, and difficulties in wound healing. The present work is an in-depth review of the current understanding of the influence of obesity on the management and outcome of severe burns.

摘要

肥胖及其相关的医学、社会和经济影响是多因素相关的慢性疾病,对包括烧伤在内的严重创伤后的预后也有重大影响。除了烧伤特有的难题,如充分的高代谢反应、液体复苏和早期伤口覆盖外,肥胖患者还常伴有动脉高血压、糖尿病或非酒精性脂肪性肝病等合并症。此外,肥胖患者对严重烧伤的病理生理反应可能会增强。与体重正常的烧伤患者相比,肥胖患者不仅发病率和死亡率更高,在液体复苏、围手术期管理以及伤口愈合方面也面临挑战。本研究对目前关于肥胖对严重烧伤治疗及预后影响的理解进行了深入综述。

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