【摘 要】
：
目的：能量代谢测定系统监测指导下,予以肠内营养支持治疗神经性厌食导致的急性重度营养不良.方法：患儿为女孩,13岁10月,病史半年余,体重从41公斤降至29公斤,临床诊断为神经性厌食.患儿合并胃轻瘫、肝功损害、胰腺炎、血细胞减低、心动过缓、闭经、脑萎缩等症状.住院期间予以持续肠内营养支持,应用代谢车监测病人第1、4、7、14和第21天静息能量消耗(REE,Kcal/d),根据REE提供适宜能量,并根
【机 构】
：
首都医科大学附属北京儿童医院临床营养科 首都医科大学附属北京儿童医院消化内科
论文部分内容阅读
目的：能量代谢测定系统监测指导下,予以肠内营养支持治疗神经性厌食导致的急性重度营养不良.方法：患儿为女孩,13岁10月,病史半年余,体重从41公斤降至29公斤,临床诊断为神经性厌食.患儿合并胃轻瘫、肝功损害、胰腺炎、血细胞减低、心动过缓、闭经、脑萎缩等症状.住院期间予以持续肠内营养支持,应用代谢车监测病人第1、4、7、14和第21天静息能量消耗(REE,Kcal/d),根据REE提供适宜能量,并根据病情变化调整肠内营养制剂种类.患儿REE从最初505kcal/d逐渐增至1200kcal/d,最终经口及肠内喂养能量达1800kcal/d.营养支持过程中,观察患儿胃肠耐受情况、血电解质、肝肾功、白蛋白及前白蛋白、体重等指标. 结果：治疗期间患儿耐受良好,体重增长6kg,心率恢复正常,监测肝功、胰酶降至正常,血白蛋白上升,造血功能恢复,未出现明显钾、磷、镁等电解质紊乱. 结论：重度营养不良患儿采用代谢车测定静息能量消耗,指导持续肠内营养供给的模式科学准确可减少再喂养等并发症的发生.
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