烧伤患者能量消耗的基本变化

目的：调查烧伤患者静息能量消耗（REE）的基本情况,为烧伤患者营养治疗提供依据。方法：采用间接测热法,测量75例烧伤总体表面积（TBSA）为5%-98%患者的能量消耗情况,测量时间点为烧伤后1、2、3、7、14、21和28 d;13例正常者测定值作为正常对照。结果：①烧伤后能量代谢过程分为缓升期和高代谢期。②高代谢期因烧伤面积的增加而延长,能量消耗峰值约为正常人的1.5-2.0倍。③创面愈合后,短期内能量消耗仍高于正常人,大面积烧伤更为明显。④能量消耗持续不升或升高后又突然降低者,提示预后不良。⑤烧伤后蛋白质分解增强,糖利用相对减低,脂肪分解和利用增加。结论：烧伤后能量消耗呈规律性变化,对严重烧伤患者采取积极的营养治疗是十分必要的。

Studie of changes of resting energy expenditure regularities in Chinese burn adults

Objective:To study the changes of energy expenditure regularities in Chinese burn adults.Methods:The resting energy expenditure(REE) was observed in 75 burn adults. Results: Burn metabolism can be divided into a slow-rise stage and a sharp-rise stage.The extent of respose and lasting time in hypermetabolism were proportional to the magnitude of total body surface area(TBSA).The peak level of REE may be 1.5-2.0 times as high as control.Even after the wound healing higher level of REE may lasts for a longer period,especially in severe burns.In case of sustaining lower REE and/or shart drop of REE are observed,the outcome is usually poor.After burning,the catabolism of protein is obviously increased,the utilization of glucose is decreasd,and the mobilization and utilization of lipid are markedly increased.Conclusion:The changes of energy expenditure regularities in Chinese burn adults are showed,the nutrition treatment should be actively given in severe burn patients.