胃癌患者围手术期代谢车测量静息能量消耗变化临床应用价值  

Value of changes of gastric cancer patients' resting energy expenditure measured by metabolic cart during the perioperative period

作　　者：范立侨[1] 刘旭 谭明[1] 檀碧波[1] 李勇[1] 贾楠[1] 李兆星[1] FAN Li qiao , LIU Xu , TAN Ming , TAN Bi bo , LI Yong , JIA Nan, LI Zhao xing(Department of Surgery Ⅲ , Fourth A f filiated Hospital, Hebei Medical University ,Shijiazhuang 050011, P. R. Chin)

机构地区：[1]河北医科大学第四医院外三科,河北石家庄050011

出　　处：《中华肿瘤防治杂志》2018年第16期1178-1181,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：河北省医学适用技术跟踪项目(G2015037)

摘　　要：目的胃癌围手术期营养风险发生率较高,并会引起相应的并发症。本研究通过与Harris-Benedict(HB)公式法对比,观察代谢车测量胃癌患者围手术期静息能量消耗(resting energy expenditure,REE)的特点及规律,探讨代谢车的优势及临床意义。方法选取2016-03-01-2017-01-31河北医科大学第四医院外三科住院行手术治疗的112例胃癌患者为研究对象,应用HB公式计算患者术前的REE,术后能量需要量再加上临床校正系数,设定为对照组。同时应用代谢车测定患者术前及术后第1、3、7天REE,设定为实验组。结果对于不同性别、年龄、病理分化程度及TNM分期的胃癌患者,HB公式组计算术前REE较代谢车测定组低,P<0.05;代谢车测定组术前及术后第1、3、7天的REE比较,差异均有统计学意义,P<0.05。胃癌患者术前REE随年龄增长而降低,呈负相关,r=-0.56,P=0.02。胃癌患者术前营养良好的REE为(1 527.3±166.9)kcal/d,中度或可疑营养不良的为(1 455.1±153.0)kcal/d,严重营养不良的为(1 411.0±94.7)kcal/d。表明术前营养状况越差,REE越低,F=4.15,P=0.02。手术时间>208min患者术后第3天REE,高于手术时间≤208min的患者,t=2.34,P=0.02。结论代谢车能动态监测胃癌患者围手术期REE,其准确性优于HB公式计算法,从而更准确、适量的进行营养支持治疗。OBJECTIVE Gastirc cancer has a higher incidence of nutritional risk in perioperative period, and will cause the corresponding complications. By comparison with the HB （Harris Benedict） formula method, this study aimed to observe the features and rules and to explore advantages and clinical significance of gastric cancer patients＇ resting ener gy expenditure measured by the metabolic cart, during the perioperative period. METHODS Totally 112 gastric cancer patients were chosen, who were treated surgically in the Third Department of General Surgery, The Fourth Hospital of Hebei Medical University, during the period of 2016-03 01 to 2017 01-31. The patients＇ resting energy expenditures （REE） were calculated with Harris-Benedict formula and postoperative energy requirements plus clinical correction fac tors. This setting is the control group. The patients＇ preoperative REE and the REE on postoperative day 1, 3, 7 were measured with metabolic cart. This setting is experimental group. RESULTS For patients with gastric cancer of different gender, age, pathological differentiation and TNM stage, the HB formula calculated REE before operation was lower than metabolic cart （P〈0.05）, and the comparison between REE before operation and the first, third, seventh days after operation was significant （P〈0. 05）. The preoperative REE decreased with age, and it had a negative correlation（r=-0.56, P=0.02）. Gastric cancer patients＇ preoperative REE of well-nourished group was （1 527.3±166.9） kcal/d, and suspected malnutrition group was （1 455.1±153.0） kcal/d, and malnourished group was （1 411.0±94.7） kcal/d. So preoperative nutritional status was worse, and REE was lower （F=4.15, P=0.02）. The operation time 〉208 min patients＇ third days after operation REE were higher than that of patients whose operation time 4208 min. CONCLUSION Metabolic cart is able to monitor the changes of gastric cancer patients＇ REE, and its accuracy is better than HB formula calculation method. Sincer

关 键 词：胃肿瘤 静息能量消耗 代谢车 围手术期 整体营养状况评量表 

分 类 号：R735.2[医药卫生—肿瘤]