外科理论与实践2023，Vol.28Issue(5)：441-447,7.DOI:10.16139/j.1007-9610.2023.05.09
影响严重烧伤病人尽早肠内营养的主要因素
Factors influencing early using enteral nutrition in severe burn patients
摘要
Abstract
Objective To analyze the main factors affecting early using enteral nutrition and the effect of enteral nutrition within 72 h after burning on outcomes by presenting a retrospective cohort study of 11 years of hospitalization data,to provide evidence for enteral nutrition regimens for severe burn patients.Methods A retrospective study analyzed adult extensive burn patients between January 2009 and December 2020.Patients enrolled in this study who admitted to the burn department within 24 h after burning and with a burned area of more than 30%.Univariate and multiple regression were used to analyze the main factors affecting early using enteral nutrition in patients with severe burn.Non parametric Mann-Whitney U test was used to compare the main influencing factors of enteral nutrition implementation within or after 72 h,as well as the impact on the treatment outcomes such as 28-day survival rate and in hospital survival rate.Results The univariate analysis found that total burn area,full-thickness burn area,burn type,and inhalation injury were the main factors of the time to initation of enteral nutrition in patients with severe burn(P<0.05).Incorporating the above single factors into multiple regression analysis,we found that the main factors affecting enteral nutrition using in patients with severe burn were full-thickness burn area(P=0.017)and inhalation injury(P=0.001).To analysis whether enteral nutrition was started within 72 h after burning,we found that inhalation injury and larger area of full-thickness burn area in patients was the main factors for initiating enteral nutrition.After matching injury situation with pre-injury situation,we found that using enteral nutrition within or after 72 h after injury were no significant differences in the survival rate,28-day survival rate,and positive blood culture rate(P>0.05),but was associated with the lower incidence of bacteria positive in intravenous catheters(P=0.001)and the lower rate of parenteral nutrition treatment used within 7 d after burning(P= 0.001).Conclusions The main factor for influencing early implement enteral nutrition in patients with severe burn were large area of full-thickness burn and inhalation injury.Enteral nutrition using within 72 h after burning reduces the incidence of catheter infection and the use of parenteral nutrition,thereby reducing the risk of treatment in patients with severe burn.关键词
大面积烧伤/肠内营养/肠外营养/导管感染Key words
Extensive burn/Enternal nutrition/Parenteral nutrition/Catheter infection分类
医药卫生引用本文复制引用
张寅,窦懿,张勤,汪雯靓,沈晓娴,马珍珠,吴蓓雯..影响严重烧伤病人尽早肠内营养的主要因素[J].外科理论与实践,2023,28(5):441-447,7.基金项目
上海交通大学医学院科技基金(Jyhz2126) （Jyhz2126）
