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

杨婷婷; 关珂; 杨阳; 王雯; 王卫香; 白军伟; 张涵; 周杨; 李静; 甘勇; 申丽君

doi:10.16766/j.cnki.issn.1674-4152.002712

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

doi: 10.16766/j.cnki.issn.1674-4152.002712

杨婷婷¹,
关珂¹,
杨阳¹,
王雯¹,
王卫香¹,
白军伟²,
张涵²,
周杨²,
李静²,
甘勇³,
申丽君^4, ,

1.
河南省人民医院/郑州大学人民医院临床营养科，河南郑州 450003
2.
河南省人民医院/郑州大学人民医院胃肠外科，河南郑州 450003
3.
华中科技大学同济医学院公共卫生学院，湖北武汉 430030
4.
河南省人民医院/郑州大学人民医院临床医学研究中心，河南郑州 450003

基金项目:

中国博士后基金面上资助项目 2019M652544

详细信息

通讯作者:
申丽君, E-mail: shenyi611613@163.com

中图分类号: R735.2 R459.3
计量
- 文章访问数: 271
- HTML全文浏览量: 74
- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2021-07-27
- 网络出版日期: 2022-12-30

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

1.
Department of Nutrition, Henan Provincial People ' s Hospital and Zhengzhou University People ' s Hospital, Zhengzhou, Henan 450003, China

摘要

摘要: 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。
- 间接测热法 /
- 胃癌 /
- 术后 /
- 营养支持
Abstract: 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.
- Indirect thermometry /
- Gastric cancer /
- Postoperative /
- Nutritional support

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表 1 2组胃癌患者静息代谢测定结果比较(x±s，kcal/d)

Table 1. Comparison of resting metabolism measurement results between the two groups of gastric cancer patients(x±s, kcal/d)

组别	例数	能量测定值	男性能量测定值	女性能量测定值	t^a值	P^a值
研究组	36	1 557.00±432.65	1 755.13±500.48	1 330.57±179.97	5.015	＜0.001
对照组	42	1 331.87±149.65	1 397.50±172.64	1 256.86±171.93	3.741	＜0.001
t值		3.162	4.343	1.847
P值		0.002	＜0.001	0.069
注：^a为不同性别间能量测定值比较。

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表 2 2组胃癌患者术后生化指标比较(x±s)

Table 2. Comparison of postoperative biochemical indexes between the two groups(x±s)

组别	例数	时间	总蛋白(g/L)	白蛋白(g/L)	红细胞(×10¹²/L)	血红蛋白(g/L)	淋巴细胞比例	C-反应蛋白(mg/L)
研究组	36	术后1 d	48.63±5.34	30.10±4.38	3.15±0.71	116.00±16.00	0.58±0.12	162.94±28.29
		术后3 d	49.47±4.98	31.22±4.62	3.54±0.41	111.00±18.00	0.33±0.21	145.67±32.14
		术后5 d	58.16±6.11^a	38.31±3.74^a	3.77±0.46	103.00±14.00	0.57±0.18	73.98±19.09^a
		术后7 d	60.15±5.78^a	37.45±4.01^a	3.87±0.57	110.00±15.00	1.01±0.47	65.43±17.84^a
对照组	42	术后1 d	47.21±5.63	30.64±3.48	3.44±0.60	115.00±20.00	0.57±0.11	167.77±59.56
		术后3 d	48.31±5.43	30.46±4.67	3.55±0.43	106.00±13.00	0.32±0.20	141.79±29.49
		术后5 d	52.15±6.48	31.27±2.89	3.67±0.64	101.00±14.00	0.55±0.17	101.75±70.26
		术后7 d	55.84±5.18	34.65±2.97	3.76±0.47	100.00±13.00	0.89±0.37	89.45±12.38
注：与同期对照组比较，^aP < 0.05。

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表 3 2组胃癌患者感染情况和住院时间比较

Table 3. Comparison of infection and hospital stay between the two groups

组别	例数	感染(例)			住院时间(x±s，d)
组别	例数	乳糜漏	手术部位感染	肠瘘	住院时间(x±s，d)
研究组	36	0	3	0	10.95±3.99
对照组	42	1	5	1	13.69±2.98
统计量		0.574^a			3.297^b
P值		0.449			0.002
注：^a为χ²值，^b为t值。

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