Breslow R A, Hallfrisch J, Guy D G, Crawley B, Goldberg A P
Department of Human Nutrition and Food Systems, University of Maryland, College Park.
J Am Geriatr Soc. 1993 Apr;41(4):357-62. doi: 10.1111/j.1532-5415.1993.tb06940.x.
To determine the effect of dietary protein on healing of pressure ulcers in malnourished patients.
Nutritional intervention trial with the non-randomized assignment of patients by pressure ulcer stage and bed type.
Long-term care facility.
Twenty-eight malnourished patients (age = 72 +/- 18 years, mean +/- SD) with a total of 33 truncal pressure ulcers. Nine patients had stage II ulcers, eight had stage III ulcers, and 16 had stage IV ulcers.
Patients received liquid nutritional formulas as tubefeedings or meal supplements containing either 24% protein (61 g protein/L; n = 15) or 14% protein (37 g protein/L; n = 13) for 8 weeks.
There was a significant decrease in total truncal pressure ulcer surface area of the 15 patients in the 24% protein group (-4.2 +/- 7.1 cm2, P < 0.02), but not in the 13 patients in the 14% protein group (-2.1 +/- 11.5 cm2, P = NS). The change in total ulcer area correlated with both dietary protein intake per kg body weight (rs = -0.50, P < 0.01) and caloric intake per kg body weight (rs = -0.41, P < 0.03). The decrease in stage IV ulcer area in eight patients in the 24% protein group (-7.6 +/- 5.8 cm2, P < 0.02) was significantly greater (P < 0.05) than in eight patients in the 14% protein group (-3.2 +/- 16.4, P = NS). In these 16 patients, the decrease in ulcer size also correlated with dietary protein intake per kg body weight (rs = -0.63, P < 0.01).
High protein diets may improve the healing of pressure ulcers in malnourished nursing home patients.
确定膳食蛋白质对营养不良患者压疮愈合的影响。
根据压疮分期和床位类型对患者进行非随机分组的营养干预试验。
长期护理机构。
28名营养不良患者（年龄=72±18岁，均值±标准差），共有33处躯干压疮。9名患者为Ⅱ期溃疡，8名患者为Ⅲ期溃疡，16名患者为Ⅳ期溃疡。
患者接受液体营养配方奶作为管饲或膳食补充剂，含24%蛋白质（61克蛋白质/升；n=15）或14%蛋白质（37克蛋白质/升；n=13），持续8周。
24%蛋白质组的15名患者躯干压疮总面积显著减小（-4.2±7.1平方厘米，P<0.02），而14%蛋白质组的13名患者则未减小（-2.1±11.5平方厘米，P=无统计学意义）。溃疡总面积的变化与每千克体重的膳食蛋白质摄入量（rs=-0.50，P<0.01）和每千克体重的热量摄入量（rs=-0.41，P<0.03）均相关。24%蛋白质组的8名患者Ⅳ期溃疡面积减小（-7.6±5.8平方厘米，P<0.02），显著大于14%蛋白质组的8名患者（-3.2±16.4，P=无统计学意义）（P<0.05）。在这16名患者中，溃疡大小的减小也与每千克体重的膳食蛋白质摄入量相关（rs=-0.63，P<0.01）。
高蛋白饮食可能改善营养不良养老院患者压疮的愈合。
