新生儿短肠综合征远期营养评价和智力发育评估  

Nutritional and cognitive assessment:A long-term follow-up study of neonatal SBS patients

作　　者：蔡威[1] 黄娟[2] 汤庆娅[2] 冯一[2] 陶晔旋[2] 吴江[2] 王莹[2] 

机构地区：[1]上海交通大学医学院附属新华医院小儿外科,200092 [2]上海交通大学医学院附属新华医院临床营养中心,200092

出　　处：《中华小儿外科杂志》2007年第6期300-304,共5页Chinese Journal of Pediatric Surgery

基　　金：国家"十五"科技攻关计划"优生优育"项目资助(编号:2004BA709B09)

摘　　要：目的评价新生儿期短肠综合征患儿远期营养状况和智力发育状况。方法2005年11月～2006年3月间对我院1988年1月1日～2003年12月31日15年间收治的9例出生后28d内诊断为短肠综合征,并且已脱离静脉营养至少2年的患儿进行随访。随访内容包括人体测量、血液生化指标和智商测定。结果9例患儿中,1例3岁时车祸意外死亡,其余8例得到患儿本人及家长同意随访。8例患儿中,7例年龄、身高、体重正常,1例患儿肥胖,患儿体脂含量为11.1%～24.9%,血液生化指标如血红蛋白、白蛋白、免疫球蛋白均正常,1例患儿前白蛋白(Pre-ALB)低于正常(0.14g/L),1例平均红细胞体积(MCV)高于正常(103.3 fl),1例MCV低于正常(78.3 fl)。7例患儿智力发育均处于正常水平,但3例患儿存在智商分离现象,1例患儿学校成绩处于班级下游。结论短肠综合征患儿脱离静脉营养后的远期营养状况基本正常,但仍然存在问题,全面随访应坚持到静脉营养停用后的整个生长发育时期。智力发育值得重视,应纳入随访内容。Objective To evaluate the long-term nutritional status and mental development in neonatal short bowel syndrome （SBS）. Methods Nine neonatal SBS patients who had weaned off parenteral nutrition for more than 2 years were enrolled in the study. Medical records were reviewed; anthropometric measurements and blood test were assayed; IQ test and school score were documented during follow-up. Results Eight of nine patients were followed up except for one patient died in a car accident at age of three. Weight, height and BMI for age were normal in 7 children, one child was overweight. Hemoglobin, albumin, immune globulin were normal in all eight patients, though macrocytosis, microcytosis, and low prealbumin level was noted in each 1 case. IQ test for children （WPPSI and WISC） was performed in 7 patients. IQ score was normal in all 7 patients but verbal-performance discrepancy was found in 2. The other patients whose age was beyond the reference range of the IQ test mentioned above had poor school performance. Conclusions Slightly abnormality in nutritional status and cognitive development still exist in children with SBS during long-term follow-up, hence regular monitoring and intensive nutritional care are vital for patients who had intestinal adaptation. Cognitive assessment should be included in follow-up.

关 键 词：短肠综合征 营养评价 智力 随访研究 

分 类 号：R722.1[医药卫生—儿科]