代谢车在重度烧伤病人能量代谢测定中的应用  

Metabolic cart for measuring the energy metabolism in severely burned patients

作　　者：秦启红[1] 钮丹叶 刘军[1] 钱雪峰[1] 吴允孚[1] 金钧[2] QIN Qi-hong NIU Dan-ye LIU Jun QIAN Xue-feng WU Yun-fu JIN Jun(Department of Intensive Care Unit, Suzhou Municipal Hospital, Suzhou 215001, Jiangsu, China Department of Intensive Care Unit, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu , China)

机构地区：[1]苏州市立医院东区重症医学科,江苏苏州215001 [2]苏州大学附属第一医院重症医学科,江苏苏州215006

出　　处：《肠外与肠内营养》2016年第6期332-335,共4页Parenteral & Enteral Nutrition

基　　金：江苏省卫生厅科研项目资助(H201466)

摘　　要：目的:研究重度烧伤病人能量代谢特点,并分析疾病严重程度和手术等因素对静息能量消耗(REE)的影响。方法:将机械通气治疗的20例重度烧伤病人,通过代谢车测定REE,并将伤后第1、3、7、14和28天测得的REE(m REE)与H-B公式计算所得REE(p REE)相比较。同时,比较APACHEⅡ评分≥15分与<15分组、手术前1 d与术后24 h的m REE。结果:1伤后第1、3、7、14和28天时,m REE值介于p REE 1.5与p REE 2.0之间。2APACHEⅡ≥15分组的m REE高于APACHEⅡ<15分组(P<0.05)。3术后24 h的m REE水平较术前1 d显著降低(P<0.05)。结论:重度烧伤病人应用代谢车测定的REE介于p REE 1.5与p REE 2.0之间。病情危重程度和手术可能对REE水平有影响。Objective： To study the energy metabolism in severely burned patients and analyze the effects of operation and severity of illness on REE. Methods： 20 cases of severe burns with mechanical ventilation were enrolled. On the 1st, the 3rd, the 7th, the 14th and 28th day, resting energy expenditure （REE） were measured by the metabolic cart and were compared with pREE. The difference of mREE was observed between the APACHE Ⅱ score ≥ 15 group and APACHE Ⅱ 〈 15 group. The difference of mREE was compared before and after operation. Results ： The values of mREE were between pREE 1.5 and pREE 2.0 on the 1st, the 3rd, the 7th, the 14th and 28th day. The mREE of APACHE Ⅱ ≥ 15 group were significantly higher than that of APACHE Ⅱ〈 15 group （P 〈 0.05 ）. The level of mREE after operation was significantly lower than that before operation （P 〈 0. 05 ）. Conclusion ： The values of mREE aer between pREE 1.5 - 2.0 in sever bum patients. Severity of illness and operation possibly have the effect on the level of REE in these patines.

关 键 词：重度烧伤病人 代谢车测定 能量代谢测定 

分 类 号：R644[医药卫生—外科学] R459.3[医药卫生—临床医学]