灼傷傷に対する代謝反応のサポート
David N Herndon1, Ronald G Tompkins
1Shriners Hospital for Children, 815 Market Street, Galveston, TX 77550, USA. dherndon@utmb.edu
Lancet (London, England)
|June 9, 2004
まとめ
重度の火傷は,長期にわたる代謝障害を引き起こします. 効果的な戦略には,早期の創傷ケア,栄養補助,運動,および痩せた体質の保全のためにオキサンドロロンなどのアナボリック剤が含まれます.
科学分野:
- 代謝障害とリハビリ科学.
背景:
- 重度の火傷は,食分解を含む長期間の代謝障害を誘発し,患者の回復と社会復帰を妨げます.
- これらの長期的な影響を軽減するには,効果的な管理戦略が不可欠です.
研究 の 目的:
- 重度の火傷の管理のための効果的なアナボリック戦略の概要を述べる.
- 低毒性で費用対効果のある薬理学的治療法を特定し,痩身量減少を最小限に抑える.
主な方法:
- 重度の火傷に対する既定および代替のアナボリック/アンチカタボリック戦略のレビュー.
- 薬理学的薬剤の有効性と安全性の評価.
主要な成果:
- 非薬理学的戦略には,早期の傷切除/移植,セプシス管理,熱環境制御,高カロリー/タンパク質の腸内栄養,運動などがあります.
- 薬理学的選択肢には,アナボリック剤 (再結合ヒト成長ホルモン,インスリン,オキサンドロロン) と抗カタボリック薬 (プロプラノロール) が含まれる.
- 継続的な低用量インスリン注入,プロプラノロール,オキサンドロロンは,最も費用対効果が高く,毒性が最も低い薬理学的治療法として特定されています.
結論:
- 重度の火傷の管理には,外科的,栄養的,環境的,運動ベースの介入の組み合わせが不可欠です.
- 薬理学的介入,特にインスリン,プロプラノロール,オキサンドロロンは,痩身量を維持するための効果的で安全な補助剤を提供します.
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