Problems of protein nutrition in burned patients
Problems of protein nutrition in burned patients
复制标题
DOI：
10.1097/00000658-194308000-00005
复制
发表时间：
1943-07-01
影响因子：
9
通讯作者：
Lund, CC
中科院分区：
文献类型：
--
作者：
Taylor, FHL;Levenson, SM;Lund, CC
虽然烧伤病人的治疗通常被认为是一个外科问题，但必须经常考虑到许多潜在的生理、代谢和临床并发症。通常情况下，成功或失败的精心计划和良好执行的外科手术，如植皮，取决于早期识别和有效处理这些潜在的障碍。烧伤并发症可包括感染、休克（即刻或晚期）、贫血、肾或肝功能紊乱。所有这些因素都会延迟愈合。任何或所有这些因素的存在也可能对患者的代谢产生深远的影响。我们有机会研究大量烧伤病人的某些代谢异常。最早的6f这些调查的细节在别处给出。[5]本信函只涉及这个大问题的一个方面，即烧伤病人的蛋白质代谢问题，在一系列63名病人中经常发生低蛋白血症，对这些病人进行了足够数量的实验室观察。在一些患者中，低蛋白血症是一过性的，可能与早期血浆丢失有关。在其他人中，它持续了一段时间，但并不严重，并对含有100至125 Gm的高蛋白饮食有反应。蛋白质每天。这些饮食补充有25至30 Gm的啤酒酵母和其他添加的维生素补充剂A，并且含有约3000卡路里。其他患者对sucl饮食没有反应，或不能摄入。该组由所有研究的患者中最严重的烧伤组成，在他们中，低蛋白血症变得进行性，并经常达到全身水肿的水平。血浆以持续性表面渗出物形式的简单损失不能单独解释低蛋白血症 * 提交给美国外科协会，辛辛那提，俄亥俄州，5月
ALTHOUGH THE TREATMENT of the burned patient is usually regarded as a surgical problem, nunmerous underlying physiologic, metabolic and clinical complications must be constantly borne in mind. Frequently, the success or failure of carefully planned and well executed surgical procedures, such as skin grafting, depends upon the early recognition and effective handling of these underlying disturbances. Infection,'shock, immediate or late, 2 anemia, 3 and disturbances of kidney or liver function4 may occur as complications of burns. All these factors tend to delay healing. The presence of any, or all, of these factors may also have a profound effect on the metabolism of the patient. An opportunity has been afforded to study some of the abnormalities of metabolism in a large series of burned patients. The details of the earliest 6f these investigations are given elsewhere. 5 The present communication deals with only one aspect of this very large problem, namely, the problem of protein metabolism in the burned patient.Hypoproteinemia occurred frequently in a series of 63 patients upon whom a sufficient number of laboratory observations were made. In some patients, hypoproteinemia was fugitive, and was probably associated with early loss of plasma. In others, it persisted for some time, but was not severe and responded to high protein diets containing from ioo to I25 Gm. of protein per day. These diets were supplemented with 25 to 30 Gm of brewers yeastt and other added'vitamin supplements, A and contained approximately 3000 calories. Other patients did not respond to, or could not ingest, sucl diets. This group was composed of the most severely burned of all the patients studied, and in them the hypoproteinemia became progressive, and often reached the anasarca level. Simple loss of plasma in the form of persistent surface exudate could not alone account for the hypoproteinemia* Presented before the American Surgical Association, Cincinnati, Ohio, May