CAJ | 학술논문

目的：探讨间接能量测定系统（简称：代谢车）在重型颅脑损伤患者治疗中的应用及其临床意义。方法85例重型颅脑损伤患者，按照随机数字表法分为代谢车组43例与常规组（ HB公式组）42例，分别应用代谢车与Harris－Benedict公式法测算出患者所需的静息能量消耗值（ REE），指导营养供给，将能量消耗数据转换成代谢趋势图，并进行分析比较。结果两组患者入院第7天与第14天的营养指标组内比较差异有统计学意义（ P＜0．05），组间比较差异无统计学意义（ P＞0．05）；代谢车组入院后第1、7、14天的REE值明显低于HB公式组，差异有统计学意义（ P＜0．05）；在第3天时两组所测值相近且差异无统计学意义（ P＞0．05）。代谢趋势图示代谢车组日需能量总体上低于HB公式组（ P＜0．05）；死亡患者死亡前3天的能量消耗急聚下降。结论代谢车测定重型颅脑损伤患者的REE值明显低于HB公式法测算值，所绘制的代谢变化趋势图可以直观反映重型颅脑损伤患者伤后的代谢变化，对病情的判断有一定帮助；根据代谢车测定的REE值提供能量更准确且节约营养费用。
목적：탐토간접능량측정계통（간칭：대사차）재중형로뇌손상환자치료중적응용급기림상의의。방법85례중형로뇌손상환자，안조수궤수자표법분위대사차조43례여상규조（ HB공식조）42례，분별응용대사차여Harris－Benedict공식법측산출환자소수적정식능량소모치（ REE），지도영양공급，장능량소모수거전환성대사추세도，병진행분석비교。결과량조환자입원제7천여제14천적영양지표조내비교차이유통계학의의（ P＜0．05），조간비교차이무통계학의의（ P＞0．05）；대사차조입원후제1、7、14천적REE치명현저우HB공식조，차이유통계학의의（ P＜0．05）；재제3천시량조소측치상근차차이무통계학의의（ P＞0．05）。대사추세도시대사차조일수능량총체상저우HB공식조（ P＜0．05）；사망환자사망전3천적능량소모급취하강。결론대사차측정중형로뇌손상환자적REE치명현저우HB공식법측산치，소회제적대사변화추세도가이직관반영중형로뇌손상환자상후적대사변화，대병정적판단유일정방조；근거대사차측정적REE치제공능량경준학차절약영양비용。
Objective To explore the clinical application and significance of the critical care management system ( metabolic vehicle ) in the treatment of patients with severe traumatic brain injury .Methods From December 2013 to June 2014 ,85 patients with severe traumatic brain injury were enrolled in and randomly divided into the group (43 cases)and Harris-Benedict(HB)formula group (42 cases).The resting energy expenditure (REE)of the patients was calculated by using metabolism vehicle and Harris-Benedict for-mula method,respectively,to guide nutrient supply.The energy consumption data was transformed into metabolic trend diagram and compared between the two groups .Results There was a significant difference in nutritive index within the groups on the 7th day and the 14th day after admission(P <0.05)but no significant difference between the two groups .The REE values in the metabolic vehicle group on the 1st,7th and 14th days after admission were significantly lower than that in the HB formula group (P<0.05).However,the values on the 3rd day were not significantly between the two groups .There was a significant difference in the metabolic trends diagram between the two groups and the energy consumption in the metabolic vehicle group was generally lower than that in the HB formula group.The energy consumption dropped precipitously on the 3 days before the death .Conclusion The REE values of patients with se-vere traumatic brain injury measured by metabolism vehicle are significantly lower than that calculated with the HB formula .The dia-gram of metabolic vehicle can accurately reflect the metabolic changes of the patients that can help to judge the disease .In addition ,it may provide more accurate energy and cut down the cost of nutrition according the REE value calculated by the metabolism vehicle .