间接测热法与预测公式对肝脏术后患者能量消耗评估的差异性分析

高明; 周华; 朱研; 彭威; 许媛

doi:10.13201/j.issn.1009-5918.2021.01.009

间接测热法与预测公式对肝脏术后患者能量消耗评估的差异性分析

- 清华大学附属北京清华长庚医院重症医学科清华大学临床医学院(北京, 102218)
基金项目:
北京市属医院中心科研培育计划项目(No:PX2017038)

详细信息

通讯作者: 周华,E-mail:icuzhouhua@163.com

中图分类号: R459.3

收稿日期: 2020-10-23

Analysis of the difference between indirect calorimetry and predicted formula in evaluating energy expenditure of patients after liver surgery

- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China

More Information

Corresponding author: ZHOU Hua, E-mail: icuzhouhua@163.com

Received Date: 23 October 2020

摘要

摘要: 目的:分析间接能量代谢测定法(IC)与不同预测公式在肝脏术后患者能量消耗评价的一致性与相关性。方法:选取2019年4月1日-2020年5月31日期间我院重症医学科收治的肝脏手术患者共47例作为研究对象。使用IC法测量入ICU后24 h内的静息能量消耗(REE)。此外,分别应用Harris-Benedict公式、Penn State公式以及公斤体重法(25 kcal·kg^-1·d^-1)计算患者的能量消耗,并以IC法作为“金标准”,绘制Bland-Altman图,分析REE与公式预测值的一致性;采用相关分析比较各测量方法之间的相关性。结果:47例患者纳入研究,IC测定REE明显高于H-B公式估算值[(1645.9±380.4)kcal/d vs.(1484.1±232.8)kcal/d,P=0.014],公斤体重法、Penn State公式计算法与IC测定值相比,差异无统计学意义。Bland-Altman分析显示,Penn State公式计算法与IC测定值整体一致性较好,相关性分析提示二者之间存在明显相关性(r=0.78,P<0.01)。结论:间接测热法仍是评估肝脏术后患者实际能量消耗的金标准。H-B公式不能准确估算肝脏术后患者的静息能量消耗,Penn State公式与REE实测值一致性较高,更适合指导肝脏术后患者的能量需求评估。
- 肝脏术后 /
- 能量消耗 /
- 经验能量估算 /
- 间接能量测定
Abstract: Objective: To analyze the consistency and correlation between indirect calorimetry(IC) and different prediction formulas in the evaluation of resting energy expenditure(REE) in patients receiving liver surgery.Methods: Patients who received liver surgery admitted to department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital from April 2019 to May 2020 were enrolled. The IC method was used to measure the resting energy expenditure(REE) within 24 hours after entering the ICU. In addition, the Harris-Benedict formula, Penn State formula and kilogram weight method(25 kcal·kg^-1·d^-1) were used to calculate the energy expenditure of patients, and the IC method was used as the "gold standard" to draw the Bland-Altman diagram and analyze The consistency between REE and the formula predicted value.Pearson correlation analysis was used to compare the correlation between the measurement methods.Results: Forty-seven patients were included in the study. The IC measured REE was significantly higher than the estimated value of the Harris-Benedict formula(1645.9±380.4)kcal/d vs.(1484.1±232.8)kcal/d, P=0.014. Compared with the IC measurement value, the kilogram weight method and Penn State formula calculation method had no significant difference. Bland-Altman analysis showed that the Penn State formula calculation method was consistent with the IC measured value, and the correlation analysis indicated that the two methods were significantly correlated(r=0.78, P=0.000).Conclusion: Indirect calorimetry is still the gold standard for evaluating the actual energy consumption of patients after liver surgery. The Harris-Benedict formula cannot accurately estimate the resting energy consumption of patients after liver surgery. Penn State formula has a high consistency with the measured value of REE, which is more suitable for guiding the energy demand assessment of patients after liver surgery.
- liver surgery /
- energy consumption /
- predicted energy estimation /
- indirect calorimetry

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