新生儿手术前后能量代谢特点研究  

Study on energy metabolism in perioperative newborns

作　　者：陶晔璇[1] 蔡威[1] 汤庆娅[1] 冯一[1] 王莹[1] 费延文[1] 

机构地区：[1]上海第二医科大学附属新华医院小儿外科

出　　处：《中华小儿外科杂志》2005年第3期113-115,共3页Chinese Journal of Pediatric Surgery

基　　金：上海市百人计划(00JG05053)资助

摘　　要：目的通过对新生儿进行术前及术后连续7 d的静息能量代谢值(resting energy expenditure,REE)测定,了解新生儿围术期能量代谢的特点,以提供合适的术后能量供给值.方法1999年6月～2003年6月期间接受手术新生儿患儿共24例(男/女:15/9),于术前24 h内接受间接能量测定,术后第1 d起每日接受1次复测,连续7 d,比较他们手术前后静息能量消耗变化,并检验实测REE值与预计值的符合率.结果术后与术前的静息能量消耗值无统计学差异;不同应激程度新生儿术后REE值组间比较差异无显著性意义.实测REE值与预计值相比,均低于公式预计值,差异有显著性意义(P＜0.01).预计值平均高出实测REE值18.5%.结论新生儿术后能量消耗与术前相比无显著增高,但存在个体差异.不同应激状态对新生儿静息能量代谢值无影响.Schoefield公式预计值较新生儿实际测定REE值平均高出18.5%,按该公式指导术后新生儿喂养有引起过度喂养的危险.Objective To clarify the characteristics of resting energy expenditure (REE) in surgical newborns.Methods Twenty-four surgical infants (boys/girls: 15/9) from the pediatric surgical department between June 1999 and June 2003 entered the study. Indirect calorimetry was used to measure REE of all the patients before operation, and 1~ 7d after operation. Clinical data were collected, including the baby's age, weight, height, diagnosis, the operative method, site and duration, the level of the C-reaction protein at the first day after operation.Results The REE before operation did not differ significantly from the postoperative values (paired t-test,P> 0.05). The predicted REE was significantly higher than the measured REE both before and after operation (P< 0.01).Conclusions The mean REE of newborn didn't increase after operation. The value calculated from the predicted equation may not be suitable for neonatal energy supplement in clinical practice.

关 键 词：新生儿 术前及术后 手术前后 静息能量消耗 能量代谢 REE 围术期 能量供给 检验 

分 类 号：R726.1[医药卫生—儿科]