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目的:研究重度烧伤病人能量代谢特点,并分析疾病严重程度和手术等因素对静息能量消耗(REE)的影响。方法:将机械通气治疗的20例重度烧伤病人,通过代谢车测定REE,并将伤后第1、3、7、14和28天测得的REE(m REE)与H-B公式计算所得REE(p REE)相比较。同时,比较APACHEⅡ评分≥15分与<15分组、手术前1 d与术后24 h的m REE。结果:1伤后第1、3、7、14和28天时,m REE值介于p REE 1.5与p REE 2.0之间。2APACHEⅡ≥15分组的m REE高于APACHEⅡ<15分组(P<0.05)。3术后24 h的m REE水平较术前1 d显著降低(P<0.05)。结论:重度烧伤病人应用代谢车测定的REE介于p REE 1.5与p REE 2.0之间。病情危重程度和手术可能对REE水平有影响。
Objective: To study the characteristics of energy metabolism in patients with severe burn and analyze the influence of disease severity and operation on rest energy expenditure (REE). Methods: Twenty patients with severe burn treated with mechanical ventilation were measured REE by metabolic vehicle and the REE (m REE) measured on the 1st, 3rd, 7th, 14th and 28th days after injury were compared with the REE (p REE) compared. At the same time, m REE was compared between APACHEⅡ score≥15 and <15, 1 d before operation and 24 h after operation. Results: At 1, 3, 7, 14 and 28 days after injury, the m REE value was between p REE 1.5 and p REE 2.0. The m REE of 2APACHEⅡ≥15 group was higher than that of APACHEⅡ <15 group (P <0.05). The level of m REE at 24 h after operation was significantly lower than that at 1 d before operation (P <0.05). CONCLUSIONS: The REE measured by metabolic carts for patients with severe burn is between p REE 1.5 and p REE 2.0. The severity of the illness and surgery may have an impact on REE levels.