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目的 :探讨以基础能量消耗 (BEE)的不同倍数提供热能进行肠外营养 (PN)治疗高龄全身炎症反应综合征(SIRS)病人的效果。 方法 :采用随机对照方法 ,将 2 4例高龄 SIRS病人分为两组 ,一组 PN时按 BEE的 1.2倍提供热能 ,另一组按 BEE的 1.5倍提供热能 ,均治疗 6天。 结果 :两组在改善血清蛋白和氮平衡方面的效果相同 ;1.2 BEE组 PN支持的代谢性并发症发生率为 8.33% (1/ 12 ) ,1.5 BEE组为 5 8.3% (7/ 12 ) (P<0 .0 5 ) ;两组 PN后 APACHE 评分均下降 (P<0 .0 5 ) ,1.2 BEE组 APACHE 评分下降较 1.5 BEE组显著 (P<0 .0 5 ) ;1.2 BEE组多器官功能衰竭 (MOF)发生率 2 5 .0 % (3/ 12 ) ,1.5 BEE组为 41.7% (5 / 12 )。 结论 :应用 PN治疗高龄 SIRS时以 BEE的 1.2倍提供热能较为合理
OBJECTIVE: To investigate the effect of parenteral nutrition (PN) treatment of elderly patients with systemic inflammatory response syndrome (SIRS) providing heat at different multiples of basal energy expenditure (BEE). Methods: Twenty-four patients with advanced SIRS were divided into two groups according to a randomized controlled trial. One group received thermal energy 1.2 times of BEE and the other 1.5 times of BEE provided thermal energy for 6 days. Results: The two groups had the same effect in improving serum protein and nitrogen balance. 1.2 The incidence of metabolic complications supported by PN in BEE group was 8.33% (1/12) and in 8.3 BEE group was 8.3% (7/12) ( P <0.05). The APACHE scores of both groups decreased after PN (P <0.05), while the APACHE score of 1.2 BEE group decreased significantly (P <0.05) than that of 1.5 BEE group The incidence of functional failure (MOF) was 25.0% (3/12) in the 1.5 BEE group and 41.7% (5/12) in the 1.5 BEE group. CONCLUSIONS: It is reasonable to provide thermal energy 1.2 times BEE when using PN to treat elderly SIRS