中等手术创伤对能量代谢的影响

Impact of moderate surgical trauma on resting energy expenditure

为了解中等手术创伤对能量代谢的影响 ,作者采用计算机控制的间接热能监测仪测定择期胆囊切除术病人手术前后的静息能量消耗 ( REE)。结果表明 ,男性病人术后第 1、2、3、4天和第 7天的 REE与术前的 REE比 (称应激因子 ,stress factor,SF)分别为 1.18± 0 .0 8、1.15± 0 .0 8、1.0 9± 0 .0 7、1.0 2± 0 .0 5和 1.0 1± 0 .0 6;女性病人为 1.13± 0 .0 7、1.11± 0 .0 5、1.0 8± 0 .11、1.0 2± 0 .0 7和 0 .99± 0 .0 4 ;术后前 3d明显高于术前 ( P<0 .0 1) ,前 3d SF平均值男女病人分别为1.14± 0 .0 9和 1.11± 0 .0 8,术后第 4天开始与术前无明显差异。提示中等手术创伤后早期能量代谢会有一定程度的增高 ,男、女病人约增加 14%和 11%。

The present study was undertaken to assess the impact of moderate surgical trauma on energy expenditure in 39pa- tients(men,n=1 9;women,n=2 0 ) under- going elective cholecystectomy.The REE was estimated on day before operating and 1～ 7days post operation by indirect col- orimetry.The result showed that the REE on the first3postoperative days was sig- nificantly elevated as compared to their preoperative values (P <0 .0 1 ) ,and the mean value of stress factor (SF = REEpostoperative REEpreoperative) in first 3days was higher than that on4th and7th day(P< 0 .0 1 ) (men,1 .1 4± 0 .0 9,1 .0 2± 0 .0 5 and 1 .0 1± 0 .0 6 ;women1 .1 1± 0 .0 8,1 .0 2± 0 . 0 7and 0 .99± 0 .0 4on the 1 st～ 3rd,4th and 7th postoperative days respectively) . The REE returned to normal value nearlon postoperative day4.In conclusion,the elective moderate surgery can increase the energy expenditure in patients by1 4% in men and1 1 % in women during the first3 postoperative days.