先天性心脏病患儿围手术期营养评价  

The preoperative nutritional assessment in children with congenital heart disease

作　　者：王海燕[1] 刘岩[2] 骆彬[1] 申红[2] 胡环宇[1] 耿玉兰[3] 李增宁[1] 

机构地区：[1]河北医科大学第一医院营养科,河北石家庄050031 [2]河北医科大学第一医院心脏外科,河北石家庄050031 [3]河北医科大学第一医院检验科,河北石家庄050031

出　　处：《蚌埠医学院学报》2011年第7期783-785,共3页Journal of Bengbu Medical College

摘　　要：目的:通过对先天性心脏(CHD)病患儿术前、术后进行营养评价,为手术方案的选择及营养支持干预提供参考依据。方法:收集河北医科大学附属第一医院心外科5～10岁CHD患儿62例,于入院后2～3 d和手术后7～14 d进行体格测量和实验室检测,记录各项客观营养评价指标,进行营养评价。结果:营养正常者37例,低体重者18例,轻度营养不良者6例,中度营养不良者1例。患儿中5、6和10岁男童实际身高和5岁男童实际体重、5～10岁女童实际身高和6～10岁女童实际体重均明显低于正常同年龄组儿童的标准身高体重(P<0.01)。术后体重、头围、上臂围、肱三头肌皮褶厚度、血清白蛋白和淋巴细胞计数均低于术前(P<0.05～P<0.01)。结论:CHD患儿较正常发育儿童,营养不良的发生率更高,患儿术前、术后自身比较,营养状况有所下降。根据营养评价结果,采取针对性的营养干预措施,可以促进术后恢复。Objective：To study on the assessment of preoperative and postoperative nutrition in children with congenital heart disease,and provide reference for surgical program selection and nutrition support.Methods：The data of 62 cases of 5 to 6 years old children with congenital heart disease were collected from December 2008 to December 2009 in the department of cardiovascular surgery.The physical examination and laboratory test were done when these children had been admitted for 2 to 3 days,or received the surgery for 7 to 14 days.Results：the ratio of male to female is 1∶ 0.9 in the 62 cases.The proportions of cases with normal nutrition,low weight,mild malnutrition and moderate malnutrition were 59.7%,29.0%,9.7% and 1.6% respectively.The height and weight of children with congenital heart disease were significantly lower than that of normal children with the same age.The preoperative weight,arm circumference,triceps skinfold thickness and lymphocyte counts in patients were lower than those of postoperative outcomes（P0.05）.Conclusions：Compared with the children of normal development,the children with congenital heart disease had higher incidence of malnutrition.The nutritional intervention should be adopted to promote postoperative recovery based on the results of nutrition evaluation.

关 键 词：心脏病 围手术期 营养评价 营养不良 小儿 

分 类 号：R541[医药卫生—心血管疾病]