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find Author "王存真" 3 results
  • 免疫营养支持在危重病中的应用

    重症患者处于高分解代谢状态。由于能量不足、蛋白质分解、机体瘦组织细胞群大量减少, 免疫系统、肠黏膜结构和功能严重受损。加上禁食和使用抗生素等而导致肠道微生态的破坏, 均可促进肠道细菌移位, 引发肠源性感染, 造成感染难以控制, 营养不良与感染形成恶性循环。上世纪70 年代以来, 营养支持已成为临床治疗中, 尤其是重症患者不可缺少的治疗措施。由于其代谢改变与普通饥饿病人有着显著的差别, 因此重症患者的营养支持有其特殊性。重症患者往往伴有免疫功能低下或障碍, 感染性并发症是影响重症病人治疗效果的主要原因, 临床给予积极的营养支持并不能使重症病人免疫功能恢复, 疾病的预后仍然较差[ 1] 。近年来, 由于药理剂量的营养配方的发展, 使营养干预进入了疾病预防和治疗的领域, 营养素增加了免疫调节成分, 以刺激机体免疫应答, 降低危重症的发病率和病死率。其中, 备受关注的营养素主要有谷氨酰胺、精氨酸、ω-3 脂肪酸和核苷酸, 学者们将这种新的营养方式称为免疫营养, 现综述如下。

    Release date:2016-09-14 11:24 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
  • 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
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