间接能量测定系统在食管癌患者术后营养治疗的临床应用  

The application of critical care management system inpostoperative nutritional therapy for patients with esophageal cancer

作　　者：陈星[1] 王凯[1] 江华[1] 

机构地区：[1]四川省医学科学院.四川省人民医院城东病区创伤外科,四川成都610101

出　　处：《实用医院临床杂志》2016年第3期76-78,共3页Practical Journal of Clinical Medicine

基　　金：四川省卫生厅科研基金资助项目(编号:130142)

摘　　要：目的探讨间接能量测定系统(简称代谢车)在食管癌患者术后营养治疗的临床应用。方法 60例食管癌术后患者采用随机数字表法分为观察组和对照组各30例,分别按代谢车监测的静息能量(REE)消耗及Harris-Benedict(HB)公式计算出的能量消耗进行营养治疗。比较两组患者每日能量需求,术后第10天测定患者淋巴细胞、血清前白蛋白、血清白蛋白、前列腺素E2(PGE2)与C反应蛋白(CRP)。结果观察组患者每日能量需求为(1436.08±203.32)k J,少于对照组每日能量需求(1543.28±262.45)k J,差异有统计学意义(P<0.01)。术后10天,观察组患者淋巴细胞(2.15±0.47)109/L、血清前白蛋白(245.49±18.26)mg/L,均高于对照组患者淋巴细胞(1.51±0.42)109/L、血清前白蛋白(201.71±15.21)mg/L,差异均有统计学意义(P<0.01)。术后10 d,观察组患者PGE2(75.49±30.27)pg/L、CRP(10.38±3.30)mg/L,均低于对照组患者PGE2(96.72±39.05)pg/L、CRP(13.62±4.78)mg/L,差异均有统计学意义(P<0.01)。结论代谢车测定的REE值明显低于HB公式法测算值。根据代谢车测定的REE值提供食管癌患者术后营养治疗更准确,对改善患者术后的营养状况、提高患者的免疫功能更具有指导意义。Objective To investigate the application of critical care management system（ metabolic vehicle） in postoperative nutritional therapy for patients with esophageal cancer.Methods Sixty patients with esophageal carcinoma were randomly divided into control or observation group after operation,30 cases in each.They were treated with nutritional therapy according to energy consumption that was based upon resting energy expenditure（ REE） estimated by metabolism vehicle or calculated with Harris-Benedict（ HB） equation.The daily energy requirements were compared between the two groups.Lymphocyte,prealbumin,albumin,prostaglandin E2（ PGE2）and C-reactive protein（ CRC） were measured on the 10 thday after operation.Results The daily energy requirements in the observation group was（ 1436. 08 ± 203. 32） / k J that was less than（ 1543. 28 ± 262. 45） / k J in the control group（ P 〈0. 01）.After 10 days of operation,blood lymphocyte and prealbumin in the observation group were（ 2. 15 ± 0. 47） ×10^9/ L and（ 245. 49 ± 18. 26） mg / L,respectively,which were higher than that in the control group[（ 1. 51 ± 0. 42） ×10^9/ L for lymphocytes and（ 201. 71 ± 15. 21） mg / L for prealbumin]（ P 0. 01）.However,PGE2 and CRP in the observation group were（ 75. 49 ± 30. 27） pg / L and（ 10. 38 ± 3. 30） mg / L,respectively,which were lower than that in the control group[（ 96. 72 ± 39. 05） pg / L for PGE2and（ 13. 62 ± 4. 78） mg / L for CRP]（ P 〈0. 01）.Conclusion The REE values of patients with esophageal cancer after operation measured by metabolism vehicle are significantly lower than that calculated with the HB formula.The diagram of clinical nutrition therapy by using metabolic vehicle can improve the nutritional status of the patients and immune function.

关 键 词：食管癌 营养治疗 免疫功能 间接能量测定系统 

分 类 号：R735.1[医药卫生—肿瘤]