Liljedahl S O, Larsson J, Schildt B, Vinnars E
Acta Chir Scand. 1982;148(5):393-400.
The effects of two isocaloric regimens for parenteral nutrition were compared on days 2 to 8 after severe burns in 16 patients. Energy expenditure, plasma catecholamines, biochemical variables and N-balance were measured. The 8 patients in group I, with mean burn size 55/25%, received fat and glucose, while the 8 in group II, mean burn size 60/40%, were given 24 g amino acid nitrogen daily in addition to the fat and glucose. The mean metabolic rate on days 2-8 after burning was 70 +/- 7 and 69 +/- 5 kcal/m2/h in groups I and II, respectively. The mean values for plasma noradrenaline in the same period were 8.35 +/- 0.89 and 7.9 +/- 0.77 nmol/l. The biochemical changes showed a pattern typical of burns. There were no intergroup differences except for urea, which was significantly higher in the group (II) receiving amino acids. The cumulative N-balance was markedly less negative 8 days after trauma (-24 g N +/- 8 g) in group II than in group I (-100 g N +/- 10 g). These results indicate that a high nitrogen intake, together with adequate energy supply, improves the N-balance significantly in the early post-burn period. The high-energy supply from fat and glucose did not seem to cause the patients additional stress.
对16例重度烧伤患者在烧伤后第2至8天比较了两种等热量肠外营养方案的效果。测量了能量消耗、血浆儿茶酚胺、生化指标和氮平衡。第一组8例患者，平均烧伤面积为55/25%，接受脂肪和葡萄糖；第二组8例患者，平均烧伤面积为60/40%，除脂肪和葡萄糖外，每天给予24g氨基酸氮。烧伤后第2至8天，第一组和第二组的平均代谢率分别为70±7和69±5kcal/m²/h。同期血浆去甲肾上腺素的平均值分别为8.35±0.89和7.9±0.77nmol/l。生化变化呈现出典型的烧伤模式。除尿素外，两组间无差异，接受氨基酸的第二组尿素水平显著更高。创伤后8天，第二组的累积氮平衡（-24g N±8g）明显比第一组（-100g N±10g）负平衡少。这些结果表明，在烧伤后早期，高氮摄入与充足的能量供应相结合，可显著改善氮平衡。脂肪和葡萄糖提供的高能量供应似乎并未给患者带来额外的应激。
