摘要
采用血气分析仪测定氧耗量、CO_2排量及用 Weir 公式计算 REE(静息能量消耗)的方法测算烧伤病人需要量,并提出了我国第一个烧伤病人热卡计算公式(第三军医大学烧伤营养公式):KJ/d=4184×体表面积 m^2+105×烧伤面积%,其前半部为病人基础需要量,每平方米1000千卡(4184千焦);后半部为烧伤需要量,对每烧伤面积%需增加105千焦的由来作了说明。介绍了体表面积的简化公式:体表面积 m^2=(身高 m-0.6)×1.5,总能量消耗除 REE 外,还应包括食物生热及活动耗能,烧伤病人在 REE 值基础上再增加多少作为每天热能供应总量,这仍是需要探讨的课题。
The caloric requirement of burn patient is usually estimated by indirect calorimetry and formulae.Apparatuses utilized to perform indirect calorimetry are expensive and can not be popularized yet.The author studied the measurement of REE(resting energy expenditure)by indirect calorimetry using gas analyzer,and explained origin of the first Chinese formula(k J/d=418×total body surface area M^2+105×% total burned surface area)for assessing caloric requirements in burned adults.The former part of this formula is the basal needs for patients,1000kcal(4184kJ)per M^2;the latter part is the demand for burns.Moreover,the origin of requiring 105KJ per% burned surface area and a simpli- fied formula[total body surface area M^2=(height M-0.6)×1.5]are illustrated.Besides REE,TEE (total energy expenditure)it also includes diet induced thermogenesis and the thermic effect of exercise. The question still needs to be investigated is that on the basis of REE,how many calories should be added to meet the daily requirement of burn patient.
