静息能量代谢测定在胃癌术后患者营养支持中的应用价值

  目的  探讨静息能量代谢测定在胃癌术后患者营养支持中的应用价值，为改善术后患者营养状况，加速术后康复提供参考。  方法  采用回顾性分析法，纳入2019年6—12月河南省人民医院胃肠外科收治的采用静息能量代谢测定法进行能量估计的36例胃癌根治术患者为研究组，纳入同期收治的采用HB(Harris-Benedict)公式法进行能量估计的42例胃癌根治术患者为对照组，比较2组患者术后第1、3、5、7天的总蛋白、白蛋白、红细胞、血红蛋白、淋巴细胞比值和C-反应蛋白，术后感染情况和住院时间。  结果  研究组术后第1天的静息能量消耗(REE)为(1 557.00±432.65)kcal/d，高于对照组HB公式估计值(1 331.87±149.65)kcal/d]，差异有统计学意义(P < 0.05)。研究组术后第5天和第7天的总蛋白、白蛋白水平均明显高于对照组(均P < 0.05)，C-反应蛋白水平明显低于对照组(均P < 0.05)。研究组住院时间(10.95±3.99)d]短于对照组(13.69±2.98)d]，差异有统计学意义(P < 0.05)。  结论  静息能量测定法可精确评估术后胃癌患者的能量变化，并为术后营养支持提供实践依据，有利于改善营养状况，对于促进术后康复具有重要价值，值得推广。 

Application value of resting energy metabolism measurement in nutritional support of postoperative patients with gastric cancer

  Objective  To explore the value of nutrition support based on resting energy metabolism measurement in postoperative patients with gastric cancer, and provide a reference for improving postoperative nutritional status and accelerating postoperative rehabilitation.  Methods  Using the method of retrospective analysis, 36 patients with radical gastrectomy treated in the Department of Gastrointestinal Surgery of Henan Provincial People ' s Hospital from June 2019 to December 2019 and estimated by resting energy metabolism method were included in the study group. In addition, 42 patients with radical gastrectomy treated in the same period and estimated by the Harris-Benedict (HB) formula method were included as the control group. The total protein, albumin, red blood cell, haemoglobin, lymphocyte ratio and C-reactive protein were measured at 1, 3, 5 and 7 days after the operation, and the postoperative infection and hospital stay were compared.  Results  The resting energy expenditure (REE) of the study group on the first day after operation was (1 557.00±432.65) kcal/d, which was significantly higher than of the control group estimated by the HB formula (1 331.87±149.65) kcal/d (P < 0.05). The levels of total protein and albumin in the study group on the 5th and 7th day after operation were significantly higher than those in the control group (all P < 0.05), and the levels of C-reactive protein were significantly lower than those in the control group (all P < 0.05). The hospital stay in the study group (10.95±3.99) d] was less than that in the control group (13.69±2.98) d], with a statistically significant difference (P < 0.05).  Conclusion  Resting energy measurement method can accurately evaluate the energy changes of postoperative gastric cancer patients, and provide a practical basis for postoperative nutritional support, which is conducive to improving the nutritional status and has important value in promoting postoperative rehabilitation.