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成人严重烧伤患者的营养治疗:一项回顾性观察研究。

Nutritional therapy among adult patients with severe burns: A retrospective observational study.

机构信息

Department of Clinical Nutrition, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei, China.

Department of Pharmacy, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, Hubei, China. Email:

出版信息

Asia Pac J Clin Nutr. 2024 Dec;33(4):496-502. doi: 10.6133/apjcn.202412_33(4).0004.

Abstract

BACKGROUND AND OBJECTIVES

The objective of this study was to examine the effects of nutritional therapy in adult patients with severe burns.

METHODS AND STUDY DESIGN

Sixty adult patients with severe burns were enrolled. Data on nutritional intake through enteral nutrition (EN) or parenteral nutrition (PN) on days 7, 14, 21, and 28 post-injury were collected. Patients were divided into target and non-target groups according to whether their energy or protein intake reached the target. Age, length of ventilation, and total bilirubin (TBIL), albumin (ALB), prealbumin (pALB), and C-reactive protein (CRP) concentrations of patients were recorded.

RESULTS

The percentage of protein targets with protein delivery was lower than that of energy target with energy delivery. The ratio of PN protein to total protein was lower than that of PN energy to total energy on days 7, 14, 21, and 28 (p<0.001, p<0.001, p=0.001, and p=0.003, respectively). Compared to the non-target group on day 21, the target group was younger, had lower TBIL on day 7, higher ALB and pALB on day 21, and lower CRP on day 14 (p=0.025, p=0.021, p=0.028, p=0.029, and p=0.049, respectively). Multivariate logistic regression analysis showed that older age and longer ventilation were independent risk factors in patients who did not meet the nutritional target on day 21 (p=0.026 and p=0.043, respectively).

CONCLUSIONS

The protein intake of adult patients with severe burns was low. Compared to the non-target group, the target group had better laboratory test results. Older age and longer ventilation were independent risk factors for patients not meeting the nutritional target.

摘要

背景与目的

本研究旨在探讨营养治疗对成年严重烧伤患者的影响。

方法与研究设计

纳入 60 例成年严重烧伤患者。收集伤后第 7、14、21 和 28 天通过肠内营养(EN)或肠外营养(PN)摄入的营养数据。根据能量或蛋白质摄入是否达到目标,将患者分为目标组和非目标组。记录患者的年龄、通气时间、总胆红素(TBIL)、白蛋白(ALB)、前白蛋白(pALB)和 C 反应蛋白(CRP)浓度。

结果

与能量目标相比,蛋白质输送的蛋白质目标百分比较低。PN 蛋白质与总蛋白质的比值低于 PN 能量与总能量的比值,差异有统计学意义(p<0.001,p<0.001,p=0.001 和 p=0.003)。与第 21 天的非目标组相比,目标组年龄较小,第 7 天 TBIL 较低,第 21 天 ALB 和 pALB 较高,第 14 天 CRP 较低(p=0.025,p=0.021,p=0.028,p=0.029 和 p=0.049)。多变量 logistic 回归分析显示,年龄较大和通气时间较长是第 21 天未达到营养目标的独立危险因素(p=0.026 和 p=0.043)。

结论

成年严重烧伤患者的蛋白质摄入较低。与非目标组相比,目标组实验室检测结果更好。年龄较大和通气时间较长是患者未达到营养目标的独立危险因素。

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