Analysis of nutritional treatment strategy for severe burn complicated with superior mesenteric artery syndrome
The clinical data of 4 patients with severe burn complicated with superior mesenteric artery syndrome(SMAS)admitted to Burn intensive Care Unit(BICU)were retrospectively analyzed.The patients were 3 females and 1 male,one of which was a female child.The cause of burn was flame burn,the depth was mainlyⅡ-Ⅲ°,and there were inhalation injury of different severity at admission.Patients were numbered from the youngest to the oldest.Patient No.1,2,3,and 4 were 10,30,40,and 62 years old,respectively,with a total burn area of 70%-92%and an average burn area of(80.5±12.2)%,and a Ⅲ° burn area of 55%-80%and an averageⅢ°burn area of(68.8±13.1)%.Patient No.2 was admitted directly to this hospital at 3 h post-injury,while patient No.1,3,and 4 were transferred to this hospital from an outside hospital at 456,192,and 16 h post-injury,respectively.The time of complication of SMAS was 20,35,10 and 50 d post-injury,respectively.The diagnosis of SMAS in 4 patients was determined by clinical symptoms,plain abdominal X-ray and abdominal CT results.After the diagnosis of SMAS was confirmed,the patients were treated with fasting,indwelling nasogastric tube and nasojejunal tube,gastrointestinal decompression,turning bed and prone position treatment,enteral and parenteral nutritional support.Deep burn wounds were temporarily covered with allograft skin after cutting scabs in the early stage,and the wounds were repaired with autologous MEEK skin,mesh skin or stamp skin grafts in the later stage,respectively.4 patients underwent 5,8,6,and 7 surgeries,respectively,with fasting and gastrointestinal decompression for 3,4,7,and 5 d,enteral nutritional support treatment with nasojejunal tube for 13,29,60,and 17 d,enteral nutritional support treatment with nasogastric tube for 42,70,97,and 45 d,and parenteral nutritional support treatment for 17,53,81,and 25 d.The patients were discharged from the hospital with weight gain and significant improvement in nutritional indexes,and their wounds were all completely healed,and there were no recurrences of SMAS after a followup of 6-36 months.
BurnsSuperior mesenteric artery syndromeEnteral nutritionBurn intensive care unitGastrointestinal decompression
万方数据
维普
