消化系统疾病患儿围手术期营养状况分析

doi:10.12372/jcp.2023.22e0552

临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (2): 130-133.doi: 10.12372/jcp.2023.22e0552

消化系统疾病患儿围手术期营养状况分析

盛金叶¹^,², 茅晓蒙², 牛杨², 邹晶², 陆丽娜³, 王莹³, 汤庆娅², 冯一², 蔡威¹^,⁴()

1.上海交通大学公共卫生学院（上海 200025）
2.上海交通大学医学院附属新华医院临床营养科（上海 200092）
3.上海交通大学医学院附属新华医院小儿消化营养科（上海 200092）
4.上海市儿科医学研究所（上海 200092）

收稿日期:2022-04-26 出版日期:2023-02-15 发布日期:2023-02-16
通讯作者: 蔡威电子信箱：caiw1978@163.com

Analysis of perioperative nutritional status of children with digestive system diseases

SHENG Jinye¹^,², MAO Xiaomeng², NIU Yang², ZOU Jing², LU Lina³, WANG Ying³, TANG Qingya², FENG Yi², CAI Wei¹^,⁴()

1. School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
2. Department of Clinical Nutrition, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
3. Department of Pediatric Digestive Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
4. Shanghai Institute of Pediatric Research, Shanghai,200092, China

Received:2022-04-26 Online:2023-02-15 Published:2023-02-16

摘要/Abstract

摘要：

目的了解消化系统疾病围手术期住院患儿营养不良发生率以及营养支持应用情况。方法选择2018年4月至2020年12月因消化系统疾病行相关手术、术前存在营养不良风险的住院患儿为研究对象。根据儿童主观整体营养评估工具（SGNA）结果，将患儿分为营养良好组、中度和重度营养不良组，比较不同营养状况患儿围手术期营养支持情况。结果纳入患儿310例，男191例、女119例，中位年龄20.7（6.1~80.6）月。310例患儿中，营养不良124例（40.0%），中度营养不良99例、重度营养不良25例。营养良好组和营养不良组之间年龄与疾病分布差异有统计学意义（P<0.05），营养不良组校正1个月~3岁比例较高，短肠综合征和食管裂孔疝比例较高。在124例营养不良患儿中95例（76.6%）获得营养支持。中度营养不良组中73例获得营养支持，重度营养不良组中22例获得营养支持，两组之间营养支持方式分布差异有统计学意义（P<0.05）。与营养良好组患儿相比，术前营养不良组患儿的住院天数延长，住院总费用增加，差异有统计学意义（P<0.05）。结论消化系统疾病围手术期患儿营养不良检出率较高，尤其是<3岁患儿。存在营养不良的患儿中营养支持率较高，但仍存在未予支持的情况。

关键词: 围手术期, 消化系统, 营养不良, 营养支持

Abstract:

Objective To understand the incidence of malnutrition and the application of nutritional support in children hospitalized during the perioperative period for digestive system diseases.Methods Children who underwent surgery at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine related to digestive system diseases with preoperative risk of malnutrition from April 2018 to December 2020 were selected as the studied population. Children were divided into well-nourished, moderately, and severely malnourished groups according to the results of the subjective holistic child nutrition assessment tool (SGNA), and the perioperative nutritional support of children with different nutritional status was compared. Results Three-hundred and ten (310) children were included, 191 males and 119 females, with a median age of 20.7 (6.1-80.6) months. Of the 310 children 124 (40.0%), were malnourished, 99 were moderately malnourished, and 25 were severely malnourished. The difference in age and disease distribution between the well-nourished and malnourished groups was statistically significant (P<0.05), with a higher proportion of the malnourished group correcting for 1 month to 3 years of age and a higher proportion of short bowel syndrome and esophageal hiatal hernia. Among 124 malnourished children, 95 (76.6%) received nutritional support. In the moderately malnourished group, 73 cases received nutritional support; in the severely malnourished group, 22 cases received nutritional support, and the difference in the distribution of nutritional support modalities between the two groups was statistically significant (P<0.05). Compared with children in the well-nourished group, children in the preoperative malnutrition group had longer hospital days and increased total hospital costs (P<0.05). Conclusion The detection rate of malnutrition in children with perioperative digestive system diseases is high, especially in children <3 years old. The rate of nutritional support was higher in children with malnutrition, but there were still cases of non-support.

Key words: perioperative period, digestive system, malnutrition, nutritional support

盛金叶, 茅晓蒙, 牛杨, 邹晶, 陆丽娜, 王莹, 汤庆娅, 冯一, 蔡威. 消化系统疾病患儿围手术期营养状况分析[J]. 临床儿科杂志, 2023, 41(2): 130-133.

SHENG Jinye, MAO Xiaomeng, NIU Yang, ZOU Jing, LU Lina, WANG Ying, TANG Qingya, FENG Yi, CAI Wei. Analysis of perioperative nutritional status of children with digestive system diseases[J]. Journal of Clinical Pediatrics, 2023, 41(2): 130-133.

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参考文献 12

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项目	例数	营养良好组(n=186)	营养不良组(n=124)	χ²值	P
男性	191	111(59.7)	80(64.5)	0.74	0.391
术前年龄				11.56	0.021
校正1个月~1岁	131	70(37.6)	61(49.2)
~3岁	59	32(17.2)	27(21.8)
~6岁	34	22(11.8)	12(9.7)
~12岁	74	56(30.1)	18(14.5)
~18岁	12	6(3.2)	6(4.8)
疾病				72.48	<0.001
短肠综合征	36	5(2.7)	31(25.0)
阑尾炎	36	35(18.8)	1(0.8)
巨结肠	28	23(12.4)	5(4.0)
食管闭锁	25	14(7.5)	11(8.9)
胆道闭锁	20	16(8.6)	4(3.2)
肠梗阻	13	5(2.7)	8(6.4)
食管裂孔疝	11	2(1.1)	9(7.3)
其他	141	86(46.2)	55(44.4)

组别	例数	无营养支持	术前营养支持	术后营养支持	术前联合术后营养支持	P¹⁾
中度营养不良组	99	26(26.3）	1(1.0)	43(43.4)	29(29.3)	0.014
重度营养不良组	25	3(12.0)	1(4.0)	6(24.0)	15(60.0)

组别	例数	住院天数/d	住院总费用/元
营养良好组	186	12.0(7.0~20.0)	24 619.0(15 335.1~39 277.1)
营养不良组	124	19.0(9.3~28.8)	30 293.2(19 661.2~52 138.8)
Z值		4.09	2.66
P		<0.001	0.008

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消化系统疾病患儿围手术期营养状况分析

Analysis of perioperative nutritional status of children with digestive system diseases

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