烧伤早期能量消耗变化的临床研究

目的:调查烧伤后1~7 d能量消耗(REE)的基本改变,以指导烧伤早期患者的营养治疗。方法:实测75例烧伤患者的REE,测点为烧伤后1、2、3和7 d,13名正常人测定值作为对照。结果:患者伤后1 d的REE与烧伤面积呈负相关(r=-0.658,P<0.05);伤后2、3 d则相关性不显著(r分别为-0.207和-0.264,P>0.05);而伤后7 d则为正相关(r=0.890,P<0.05)。REE的变化可分为缓升期和高代谢期,伤后REE不升或升高后又迅速降低者提示预后不良。结论:大面积烧伤患者伤后早期REE有明显的缓升阶段,营养补充应有计划进行,切忌过量补给。

Energy expenditure in burn adults in early postburn days

Objective: To study the changes of energy expenditure in burn adults on postburn day(PBD)1-7 in accordance with nutrition treatment.Methods: The resting energy expenditure(REE)was observed in 75 burn adults on PBD 1,2,3 and 7.Results: The total burn surface area was correlated with REE negatively on PBD 1(r=-0.658,P< 0.05),insignificantly on PBD 2(r=-0.207,P>0.05)and PBD 3(r=-0.264,P>0.05),but positively on PBD 7(r= 0.890,P<0.05).The REE changes could be divided into a slow-rise and a sharp-rise stage.Sustained lower REE and/or sharp drop of REE suggested poor prognosis.Conclusion: There was a slow-rise stage of REE in burn adults,and nutrition treatment should be given in a planned way in severe burn patients,especially on PBD 1-7.