Liu Y, Wang J Z
Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Zhonghua Shao Shang Za Zhi. 2021 Feb 20;37(2):126-130. doi: 10.3760/cma.j.cn501120-20201125-00499.
Severe burns trigger the stress response, cause different degrees of damage to the body, and participate in the occurrence and development of immune dysfunction and hypermetabolism after burn. Rational application of analgesic and sedative drugs is the major method of inhibiting the severe burn-induced stress response, which can alleviate the organ damages and reduce the incidence of burn sepsis. Furthermore, integrated approaches including wound management, infection control, nutritional support, and gastrointestinal tract protection, as well as sleep management, etc., collectively contribute to the alleviation of stress response after burn injury. To further improve the success rate of severe burn treatment, it is essential to study the changes of various stresses, endocrine hormones and immune patterns in patients with severe burn, to explore the mechanism and regulation of burn-induced hypermetabolism, and to reach a consensus on sedation and analgesia strategy, the management of stress response and hypermetabolism after severe burns.
严重烧伤会引发应激反应,对身体造成不同程度的损害,并参与烧伤后免疫功能障碍和高代谢的发生与发展。合理应用镇痛和镇静药物是抑制严重烧伤所致应激反应的主要方法,可减轻器官损害并降低烧伤脓毒症的发生率。此外,包括伤口处理、感染控制、营养支持、胃肠道保护以及睡眠管理等在内的综合措施,共同有助于减轻烧伤后的应激反应。为进一步提高严重烧伤的治疗成功率,研究严重烧伤患者各种应激、内分泌激素及免疫模式的变化,探索烧伤诱导高代谢的机制及调控,就严重烧伤后镇静镇痛策略、应激反应及高代谢的管理达成共识至关重要。