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目的:研究严重烧伤患者休克期经肠道给予燕麦米汤对肠道复苏的影响。方法:选取烧伤面积≥30%TBSA的患者42例,并随机分为:燕麦米汤组,伤后24h内开始经鼻肠管给予燕麦米汤;对照组,伤后24h内开始经鼻肠管给予50g/L葡萄糖盐水,连续4d,每组21例。在伤后1、2、3、4 d分别检测其血清二氨氧化酶(DAO)值及动脉血乳酸(LAC)含量,观察两组患者腹胀缓解时间、肠鸣音恢复时间等临床指标。结果:两组患者伤后血清二氨氧化酶及动脉血乳酸含量均呈下降趋势,燕麦米汤组血清二氨氧化酶在伤后2、3、4d显著低于对照组(P<0.01),而脉血乳酸含量在伤后2、3d显著低于对照组(P<0.05或0.01),治疗过程中燕麦米汤组其腹胀缓解时间、肠鸣音恢复时间、排气时间、开始完全肠内营养时间、继发感染例数均优于对照组(P<0.01)。结论:在严重烧伤休克期尽早鼻饲燕麦米汤能较好地促进肠道复苏。
OBJECTIVE: To study the effect of enteral feeding of oatmeal soup on intestinal resuscitation in patients with severe burn during shock stage. Methods: Forty-two patients with burn area≥30% TBSA were selected and randomly divided into three groups: oatmeal soup group, oatmeal soup via nasal gut tube 24h after injury; control group, nasal gut tube was given 50g / L Glucose saline, continuous 4d, 21 cases in each group. The levels of serum diammine oxidase (DAO) and arterial blood lactate (LAC) were detected at 1, 2, 3 and 4 days after injury respectively. The clinical indexes including abdominal distension time and bowel sounds recovery time were observed. Results: The levels of serum diammine oxidase and arterial lactate in both groups showed a decreasing trend. Serum diammine oxidase in oatmeal soup group was significantly lower than that in control group at 2, 3 and 4 days (P <0.01) Blood lactic acid content was significantly lower than that of the control group on the 2nd and 3rd post-injury (P <0.05 or 0.01). During the course of treatment, the laparotomy time, the recovery time of bowel sounds, the exhaust time and the time of complete enteral nutrition , Cases of secondary infection were better than the control group (P <0.01). Conclusion: Nasal feeding of oatmeal soup early in severe burn shock period can promote intestinal recovery better.