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目的:分析重型颅脑外伤病人能量消耗实测值与预计值的一致性,了解其静息代谢特点,指导临床营养供给。方法:利用间接测热法测定静息能量代谢,同时与应用H-B公式、体重法等预计能量消耗值比较,用Bland-Altman法比较实测值与预计值的一致性。结果:32例病人测定了静息能量代谢,用间接能量测定法测得的能量消耗值与其他预计值比较,差异有显著性统计学意义(P<0.05)。预计值与实测值在95%的平均差值时符合率较高,但离散值较大。而在±10%实测值的平均值范围内一致性低。结论:重型颅脑外伤病人能量代谢变异性大,使用间接测热法测定每个病人的实际能量消耗,对病人个体化供给营养提供依据。
OBJECTIVE: To analyze the consistency between the measured and predicted energy expenditure of patients with severe traumatic brain injury and to understand the characteristics of resting metabolism and to guide the clinical nutrition supply. Methods: The resting energy metabolism was measured by indirect calorimetry. At the same time, the Bland-Altman method was used to compare the predicted energy consumption with the expected energy consumption by H-B formula and body weight method. Results: The resting energy metabolism was measured in 32 patients. The energy consumption measured by indirect energy measurement was significantly different from other predicted values (P <0.05). The expected coincidence with the measured value is 95%, but the discrepancy value is larger. Consensus is low within the mean range of ± 10% of the observed value. Conclusion: The energy metabolism of patients with severe traumatic brain injury is quite variable. The actual energy consumption of each patient is determined by indirect calorimetry, which provides basis for individualized nutrition of patients.