儿童加强监护病房患儿营养状况的调查  

Nutritional assessment in a pediatric intensive care unit

作　　者：张哲哲[1] 钱素云[1] 祝益民[2] 

机构地区：[1]首都医科大学附属北京儿童医院重症医学科,北京100045 [2]湖南省人民医院儿科医学中心

出　　处：《中华急诊医学杂志》2015年第6期597-601,共5页Chinese Journal of Emergency Medicine

基　　金：首都卫生发展科研专项项目（2011-2009-04）;十二五国家科技重大专项课题（2012BAI04800）

摘　　要：目的了解危重患儿的营养状况，探讨营养状况与病情严重程度及预后的相关性，为临床对危重患儿进行合理的营养支持提供一定理论依据。方法采集2010．11-2011．01期间入住北京儿童医院儿童加强监护病房（pediatric intensive care unit，PICU）的所有患儿作为研究对象。采用前瞻性研究方法，对人组患儿的身长、体质量等人体参数进行测量及营养评估。收集基础疾病、危重病例评分、住院时间、机械通气时间等临床资料。结果196例患儿中，营养不良共43例，营养不良现患率为21．9％。营养不良组的儿童死亡危险评分大于营养正常组（P〈0．05）；机械通气使用率高于营养正常组（P〈0．05）；营养正常组患儿28d存活率高于营养不良组（P＜0．05）。结论PICU入院患儿中营养不良的患病率为21．9％。营养不良组患儿儿童死亡危险评分、机械通气使用率高于营养正常组，28d存活率低于与营养正常组，提示营养不良与疾病严重程度和预后相关。Objective To assess nutritional status of critically ill children, and to investigate the correlation of nutritional status with illness severity and clinical outcomes, so as to provide a theoretical basis for rational nutrition support of critically ill children. Methods All patients hospitalized in the pediatric intensive care unit of Beijing Children＇s Hospital from November, 2010 to January 2011 were enrolled and studied prospectively. We collected anthropometric parameters （body length/height, body weight, head circumference, etc） for nutritional assessment, as well as their clinical data such as underlying diseases, pediatric risk of mortality scores （ PRISM ）, length of hospital stay and mechanical ventilation duration. Results In 196 cases, the prevalence of malnutrition was 21.9% （43/196）. Malnutrition group had greater PRISM scores, higher mechanical ventilation rate and a lower 28-day survival rate than normal nutritional status group （ all P 〈 0. 05 ）. Conclusions The prevalence of malnutrition on admission to the PICU was high and poor nutritional status indicated greater illness severity and adverse clinical outcomes

关 键 词：危重症 营养不良 人体测量学 营养状况 小儿危重症评分 儿童死亡危险评分 疾病严重程度 预后 

分 类 号：R720.597[医药卫生—急诊医学]