牛奶蛋白诱导的过敏性直肠结肠炎患儿喂养干预研究  

Feeding intervention study on allergic proctocolitis in children induced by cow milk protein

作　　者：赵红梅[1] 游洁玉[1] 刘莉[1] 张文婷[1] 唐娟[1] 欧阳红娟[1] 陈志勇[1] 

机构地区：[1]湖南省儿童医院消化内科,长沙410007

出　　处：《中华实用儿科临床杂志》2014年第19期1455-1458,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 评估牛奶蛋白过敏性直肠结肠炎患儿的营养风险;观察喂养干预方案的变化及疗效,探讨个体化喂养干预方案的选择时机.方法 回顾性分析2012年1月至2013年7月湖南省儿童医院确诊为牛奶蛋白过敏性直肠结肠炎的171例患儿临床资料,其中非母乳喂养组139例（81.3％）.干预方案：母乳喂养组继续母乳喂养32例,非母乳喂养组中游离氨基酸配方干预36例（21.1％）,深度水解配方干预103例（60.2％）,观察喂养干预2周的疗效,随访8周、12周、24周时喂养干预配方变化及0、3、6个月营养风险评估情况.结果 171例患儿中,男∶女=1.5∶1.0;平均年龄（4.1±1.3）个月.疗效观察：干预2周共显效147例（86.0％）,其中母乳喂养组显效率为79.2％,与游离氨基酸配方组及深度水解配方组比较差异无统计学意义（P＞0.05）.随访0.5年内干预配方改变：8周：母乳喂养组30例继续母乳喂养,游离氨基酸配方粉喂养21例（12.3％）,深度水解配方粉85例（49.7％）,适度水解配方35例（20.5％）;12周：母乳喂养23例（13.5％）,游离氨基酸配方粉喂养16例（9.4％）,深度水解配方粉喂养56例（32.7％）,适度水解配方喂养76例（44.4％）;24周：母乳喂养21例（12.3％）,游离氨基酸配方粉喂养7例（4.1％）,适度水解配方喂养13例（7.6％）,普通配方喂养130例（76.0％）.于0、3、6个月进行营养风险评估（STAMP营养风险评估表）,3组在不同时期的风险评分均值比较差异均无统计学意义（P均＞0.05）.结论 牛奶蛋白过敏性直肠结肠炎患儿营养风险较低,不同的喂养干预方式对患儿的营养状态无明显影响.继续母乳喂养可有效回避牛奶过敏,人工喂养患儿干预后2周左右症状可获缓解,50％左右在3个月以上可获得部分免疫耐受,故可根据其诱导免疫耐受情况进行个体化喂养干预,减轻经济负担.Objective To assess nutritional risks in children with allergic proctocolitis induced by cow milk protein,and to observe the effects of the feeding strategies for them with different interventions in feeding,and then to identify the best time and the best way to modify feeding strategies according to different individual.Methods The effectiveness of different feeding interventions was retrospectively analyzed after 2 weeks in 171 cases with allergic proctocolitis induced by cow milk protein in Hunan Children±39;s Hospital during the period of Jan.2012 to Jul.2013.Thirty-two cases received breast feeding （18.7%） and 139 cases received non-breast feeding （81.3%）.Intervention methods：32cases with breast feeding received the same feeding method;among 139 babies with non-breast feeding group,36 were plus free amino acid （AAF） （21.1%）,and 103 were plus the extensively hydrolyzed formula （eHF）.The intervention formula changes were observed in 8,12 and 24 weeks,respectively,and nutritional risks in 0,3,6 months were assessed,respectively.Results There were 171 patients totally,male to female ratio was 1.5 to 1.0,and the average age was （4.1 ± 1.3） months.After 2 weeks,147 cases were notably effective,accounting for 86%,and in the breast feeding group 79.2% of the patients were notably effective,and there was no significance compared with the AAF group and Ehf group （P 〉 0.05）.The intervention formulation changes during the following 6 months were as follows：in 8 weeks,30 cases in the breast feeding group breastfeeding continued,2 cases turned to Ehf feeding for the lack of breast milk,21 cases were fed with AAF （12.3%）,85 cases with Ehf （49.7%）,and 35 cases with moderately hydrolyzed formula （20.5%） ;in 12 weeks：23 cases had breast feeding （13.5%）,16 cases were fed with free amino acid formula powder （9.4%）,56 cases with extensively hydrolyzed formula （32.7%）,and 76 cases with moderately hydrolyzed formula （44.4%） ;in 24 weeks：21 cases （12.3%） had br

关 键 词：直肠结肠炎 牛奶蛋白过敏性 喂养干预 儿童 

分 类 号：R725.7[医药卫生—儿科]