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  • west china medical publishers
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    find Author "王存真" 3 results
    • 免疫營養支持在危重病中的應用

      重癥患者處于高分解代謝狀態。由于能量不足、蛋白質分解、機體瘦組織細胞群大量減少, 免疫系統、腸黏膜結構和功能嚴重受損。加上禁食和使用抗生素等而導致腸道微生態的破壞, 均可促進腸道細菌移位, 引發腸源性感染, 造成感染難以控制, 營養不良與感染形成惡性循環。上世紀70 年代以來, 營養支持已成為臨床治療中, 尤其是重癥患者不可缺少的治療措施。由于其代謝改變與普通饑餓病人有著顯著的差別, 因此重癥患者的營養支持有其特殊性。重癥患者往往伴有免疫功能低下或障礙, 感染性并發癥是影響重癥病人治療效果的主要原因, 臨床給予積極的營養支持并不能使重癥病人免疫功能恢復, 疾病的預后仍然較差[ 1] 。近年來, 由于藥理劑量的營養配方的發展, 使營養干預進入了疾病預防和治療的領域, 營養素增加了免疫調節成分, 以刺激機體免疫應答, 降低危重癥的發病率和病死率。其中, 備受關注的營養素主要有谷氨酰胺、精氨酸、ω-3 脂肪酸和核苷酸, 學者們將這種新的營養方式稱為免疫營養, 現綜述如下。

      Release date:2016-09-14 11:24 Export PDF Favorites Scan
    • Treatment of critically ill patients with gas gangrene resulted in the 2008 W enchuan earthquake

      Objective To investigate the efficacy of interdisciplinary therapy in critically ill patients with gas gangrene in the 2008 W enchuan earthquake.Methods Four critically wounded patients with gas gangrene caused by Wenchuan earthquake were treated by interdisciplinary cooperation.Results Two patients received debridement and decompression were not amputated.Two amputated patients did not received futher amputation.Conclusions Interdisciplinary therapy of critically ill patients with gasgangrene in earthquake could limited the area of tissue necrosis,minimized the necessity of amputation and further amputation.

      Release date:2016-09-14 11:56 Export PDF Favorites Scan
    • Risk factors and therapy stra tegies of acute pulm onary edem a in critically ill patients after the 2008 W enchuan earthquake

      Objective To analyze risk factors and therapy strategies of critically ill patients with acute pulmonary edema(APE)after the 2008 Wenchuan earthquake.Methods Data including the level of hemoglobin,mean arterial pressure(MAP),central venous pressure(CVP),serum albumin as well as complications and liquid balance 1 week,3 days,1 day before onset of APE was collected an d an alyzed retrospectively.Resets Among 142 patients during two months after May 12 earthquake APE was detected in 17 cases for 25 times.The hemoglobin Was (86.04 ±16.31)s/L,MAP was(99.40±17.38)mm Hg,CVP Was (13.64 ±4.09)mm Hg and serum albumin was(27.80±8.10)g/L.Acute renal failure,severe infection,cardiovascular disease and extremity lost were more common in APE patients.Theliquid net intake Was (1 725.05±4 624.84)mL for one week,(1 574.70±2 857.13)mL for 3 days and (368.56±1 589.89)mL for 1 day before the onset of APE.The liquid intake Was significantly higher in young group.APE Was alleviated promptly after integrated therapy in all cases.Conclusions Traumapatients with ARF or extremity lost are prone to be compromised with APE.Severe infection and overburden of liquid may be other predisposing factors.

      Release date:2016-09-14 11:56 Export PDF Favorites Scan
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  • 松坂南