| 傅建剑.入院预后营养指数对烧伤患者液体复苏疗效的评估意义[J].浙江中西医结合杂志,2023,33(2): |
| 入院预后营养指数对烧伤患者液体复苏疗效的评估意义 |
| Significance of nutritional index on admission prognosis for fluid resuscitation in burn patients |
| 投稿时间：2022-02-28 修订日期：2022-05-17 |
| DOI： |
| 中文关键词: 烧伤 休克 预后营养指数 液体复苏 疗效 |
| 英文关键词: |
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| 中文摘要: |
| 目的 探讨入院预后营养指数(PNI)对烧伤患者液体复苏疗效的评估意义。方法 选择我院自2018年1月至2021年10月接诊的150例烧伤患者作为研究对象,根据入院血清白蛋白、淋巴细胞绝对值的检测结果,计算PNI,分为高PNI组(108例,PNI≥45)和低PNI组(42例,PNI＜45)。所有患者均接受常规液体复苏治疗,比较两组入院血清白蛋白、淋巴细胞绝对值、PNI、复苏前后血清炎症因子含量、伤后第1个24h剩余碱、尿量、补液系数、28d并发症发生情况及病死情况。结果 高PNI组复苏后1d、2d的血清白细胞介素4(IL-4)、IL-6、肿瘤坏死因子α(TNF-α)水平均低于低PNI组,差异均有统计学意义(P＜0.05)；高PNI组伤后第1个24h尿量多于低PNI组,剩余碱、补液系数均高于低PNI组,差异均有统计学意义(P＜0.05)；高PNI组28d并发症发生率、病死率分别为11.11%、9.26%,低PNI组分别为26.19%、21.43%,高PNI组28d并发症发生率、病死率均低于低PNI组,差异均有统计学意义(P＜0.05)。结论 入院PNI能反映烧伤患者液体复苏疗效,低PNI与预后不良有关,对复苏前评估及预后分析均有一定指导意义,值得进一步研究应用。 |
| 英文摘要: |
| Objective To investigate the significance of admission prognostic nutrition index (PNI) in the evaluation of fluid resuscitation in burn patients.Methods A total of 150 burn patients admitted to our hospital from January 2018 to October 2021 were selected as subjects.According to the detection results of serum albumin and absolute value of lymphocytes on admission,PNI was calculated,and they were divided into high PNI group(108 cases,PNI≥45) and low PNI group(42 cases,PNI<45).All patients received conventional fluid resuscitation treatment.Serum albumin,absolute value of lymphocytes,PNI,content of inflammatory factors in serum before and after resuscitation,residual alkali in the first 24 hours after injury,urine volume,rehydration coefficient,incidence of complications and death at 28 days were compared between the two groups.Receiver operating characteristic curve (ROC) was used to analyze the predictive efficacy of PNI on death 28 days after fluid resuscitation in burn patients.Results The levels of interleukin 4(IL-4),IL-6 and tumor necrosis factor α(TNF-α) in high PNI group are lower than those in low PNI group after 1 days and 2 days of resuscitation,the differences are statistically significant(P<0.05).The urine volume in the first 24 hours after injury in the high PNI group is higher than that in the low PNI group,and the residual alkali and fluid rehydration coefficient are higher than those in the low PNI group,with statistical significance(P<0.05).The 28d complication rate and fatality rate in the high PNI group are 11.11% and 9.26%,and the low PNI group are 26.19% and 21.43%,the 28d complication rate and fatality rate in the high PNI group are lower than those in the low PNI group,with statistical significance (P < 0.05).Conclusion PNI on admission can reflect the efficacy of fluid resuscitation in burn patients. Low PNI is associated with poor prognosis,which has certain guiding significance for pre-resuscitation evaluation and prognosis analysis,and is worthy of further study and application. |
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