间接能量测定法监测指导危重症患者营养治疗的对比研究

Comparative study on indirect calorimetry in monitoring and guiding nutritional therapy in critical patients

目的探讨代谢车监测结果对指导危重症患者合理营养治疗的效果。方法将重症监护病房患者中急性生理和慢性健康(APACHE)Ⅱ评分大于5分的70例患者随机分为观察组和对照组各35例。观察组按照静息能量消耗测定值进行营养治疗,对照组按照Harris-Benedict公式计算结果进行营养治疗,并将两组营养治疗情况进行对比分析。结果观察组患者经7 d营养治疗后,血清清蛋白、总蛋白、上臂肌围3项指标较治疗第1天提高,差异有统计学意义(P<0.05)。其中上臂肌围与对照组同时间比较,差异有统计学意义(P<0.05)。而血红蛋白、肱三头肌皮褶厚度与治疗第1天及对照组同时间比较,差异无统计学意义(P>0.05)。结论按照静息能量消耗测定值进行营养治疗较按照Harris-Benedict公式进行营养治疗效果更好。

Objective To evaluate the effect of detection result of metabolic cart to proper nutritional therapy. Methods 70 critically ill patients whose acute physiology and chronic health evaluation （APACHE） Ⅱ 〉5 in intensive care unit （ICU） were randomly divided into observation group （nutritional therapy was conducted according to resting energy expenditure determination, n=35 ） and control group （nutritional therapy was conducted according to Harris-Benedict formula, n=35 ）, The results of nutrition- al therapy in the two groups were analyzed. Results After 7-day nutritional therapy, serum albumin, total protein and mid-arm muscle circumference（MAMC） were higher than that on first day of treatment with statistically significant differenee（P〈O.05 ）. The difference of the MAMC between the two groups had statistical significance （P〈0.05）. Comparing with the 1st treatment ,the hemoglobin （Hbg） and triceps skinfold thickness （TSF） had no statistical significance （P〉0.05） ;the difference of Hbg and TSF in both groups also had no statistical significance （P〉0.05）. Conclusion Comparing with nutritional therapy guided by harris-bene- dict formula, nutritional therapy according to resting energy expenditure determination has better efficacy relatively.