- 期刊
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燒傷病人全靜脈營養之併發症
Complications of TPN in Burned Patients
摘要
燒傷與其他形式的創傷比較起來，其代謝及能量消耗較高。為了支持這樣的代謝以及傷口癒合，營養的補充是非常重要。燒傷面積大於百分之二十五體表面積的病人，在燒傷初期，消化道功能差，而使得其無法吸收足夠的熱量以迎合營養的需求。在三軍總醫院燒傷中心有百分之十四的重燒傷病人（燒傷面積大於百分之二十五體表面積），其燒傷後，由於不同的原因，至第五日仍無法接受經腸道營養（enteral feeding），接受了全靜脈營養（total parenteral nutrition）治療。從我們這些病人中，我們觀察到全靜脈營養的治療有非常高的併發症發生率。它包括了高血糖、高血鈉、低血鉀、代謝性鹼中毒以及肝功能異常等併發症。值得注意的是，這些病人可能因為其病況較差，儘管我們比其他的病人更加護監視（intensive care）及給予全靜脈營養治療，他們仍有很高的死亡率（百分之八十七點五）。所以，在給予全靜脈營養治療的同時，我們必須要格外的注意其高併發症發生率以及這些病人的高死亡率。
並列摘要
Burn injury, as in comparison to other types of mechanical trauma, has resulted in the highest levels of hypermetabolism and energy expenditure. Nutritional support has been very important in supporting the metabolism and the healing of wounds. Patients with burns ＞ 25% of total body surface area (TBSA) have initially had poor gastrointestinal function, making it difficult to deliver sufficient enteral calories to meet nutritional requirements. There were 14% major burned patients (burns ＞ 25% TBSA) in our Burn Center who could not tolerate enteral feeding and received TPN supplement during the fifth day after receiving injury for various reasons. The overall complications after TPN therapy were observed here in the small series to be above 50% including septicemia, hyperglycemia, hypernatremia, hypokalemia, metabolic alkalosis and liver function abnormalities. More carefully has been the high mortality rate coming from those patients (87.5%) whom neglected the more intensive care than another burned patient and nutrition supplement by TPN. Careful attention has been paid here to the high incidence of complications and high mortality.