重度烧伤婴儿的肠外营养平衡的护理

目的 探讨适合婴儿重度烧伤后保护性代谢改变特点的肠外营养平衡护理方法,减少传统高热量肠外营养支持、胰岛素严格控制血糖疗法治疗重度烧伤婴儿的并发症.方法 介绍我们科室制定的低热量摄入、安全使用胰岛素的肠外营养护理方法治疗60例重度烧伤婴儿的疗效.结果 60例婴儿都抢救成功,并且并发症明显减少.结论 婴儿合成、分泌和利用胰岛素的能力较成年人差,烧伤应激时比成年人更加容易出现高血糖.高热量肠外营养（葡萄糖、氨基酸、脂肪乳等）在体内代谢时要消耗体内极其大量的氧气,加重重度烧伤婴儿的缺氧症状.婴儿胰岛素代谢障碍,胰岛素蓄积容易出现延迟的致命的低血糖.我们科室制定的所有重度烧伤婴儿的肠外营养平衡支持治疗及护理方法是根据重度烧伤后婴儿的保护性代谢改变特点来制定的.

Parenteral nutrition balance support nursing measures of severely burned infants

Objective To explore parenteral nutrition （PN） balance support nursing measures suit to infants＇ protective changes of metabolizing character after severely burned,to reduce the complications of traditional high calorie PN support and keep a tight control of blood glucose by intensive insulin therapy of severely burned infants.Method Reported the therapeutic effect of low calorie PN support and a safety control of permissive hyperglycemia by un-intensive insulin therapy and nursing measures instituted by our unit applied in 60 severely burned infants.Result 60 severely burned infants were cured,with fewer complications.Conclusions The infants＇ ability to compound,excrete and utilize insulin is lower than that of adult,so infants have high blood glucose more often than adult after severely burned.High calorie PN （glucose,amino acid,fat emulsion and so on） needs amplitudinous oxygen to metabolize,which will aggravate hypoxia of severely burned infants.The infants＇ ability of metabolizing insulin is lower than that of adult,insulin will accumulate in their bodies,which will lead to delayed fatal hypoglycemia.PN balance support treatment and nursing measures of severely burned infants instituted by our unit are based on infants＇ protective changes of metabolizing character after severely burned.