摘要目的 探讨高能量密度营养乳剂的肠内营养对严重烧伤患者的临床疗效.方法 将40例烧伤总面积31%～70%,Ⅲ度烧伤面积＞11%的重症烧伤患者随机分为对照组和试验组,每组20例.两组均自烧伤后第1天开始留置鼻胃管行肠内营养.试验组采用普通饮食喂养加高能量密度营养乳剂,对照组采用普通饮食喂养.分别于营养治疗前、烧伤后第1、3、7、10、14、21天检测患者的血红蛋白、血清白蛋白和总淋巴细胞计数.计算每日氮平衡,统计并发症发生率.结果 烧伤后第14、21天,试验组血清白蛋白水平显著高于对照组(P＜0.05),两组的血红蛋白水平和总淋巴细胞计数的差异无统计学意义(P＞0.05).自烧伤后第10天起,试验组的氮平衡均显著高于对照组(P＜0.05).试验组腹胀、腹泻、恶心呕吐等并发症的发生率均低于对照组.结论 高能量密度营养乳剂能改善严重烧伤患者的氮平衡,降低肠内营养并发症的发生率.

abstractsObjective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g · kg±1 · d±1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor± ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera± tion but without significant difference [control group: (2. 24 ±0. 84) fig/ml, study group: (2. 32 ±0.92) μg/ml, normal value: (1.27 ±0.44) μg/ml]. On the post±operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31 ±1. 05) μg/ml] was significantly higher than that of control group [ (3. 04± 1. 01) μ/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with± out significant difference [ (33. 3 ±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.