低龄先天性心脏病患儿营养风险与临床结局的关系研究  

Prevalence of Moderate to High Nutritional Risk and Clinical Outcome in Young Children Aged ≤3 Years with Congenital Heart Disease

作　　者：宋佳音 郑樱[1] 肖本熙[1] 戚本华[1] 张燕军[1] 李远红[1] 王端[1] 李真[1] 马文君[1] SONG Jia-yin;ZHENG Ying;XIAO Ben-xi;QI Ben-hua;ZHANG Yan-jun;LI Yuan-hong;WANG Duan;LI Zhen;MA Wen-jun(Department of Nutrition,Guangdong General Hospital/Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]广东省人民医院广东省医学科学院营养科,广东省广州市510080

出　　处：《中国全科医学》2018年第6期698-701,共4页Chinese General Practice

摘　　要：目的对低龄先天性心脏病(CHD)患儿术前营养风险进行筛查,探讨中、高度营养风险与低龄CHD患儿临床结局的关系,为临床营养支持提供依据。方法选择2016年6—12月广东省人民医院收治的1~36个月龄的CHD患儿306例为研究对象,采用营养风险及发育不良筛查工具(STRONGkids)行营养风险筛查并根据筛查结果分为低、中、高度营养风险组。比较中、高度营养风险患儿临床结局指标。结果 306例CHD患儿术前低度营养风险组4例(1.3%)、中度营养风险组134例(43.8%)、高度营养风险组168例(54.9%)。高度营养风险组的总住院费用、住院时间、重症监护(ICU)时间、机械通气时间、术后感染率均高于中度营养风险组(P<0.05),中度营养风险组和高度营养组患儿病死率间差异无统计学意义(P>0.05)。结论 CHD患儿术前多存在中、高度营养风险,高度营养风险CHD患儿的总住院费用、住院时间、ICU时间、机械通气时间、术后感染发生率均较中度营养风险CHD患儿高。Objective To investigate the relationship between the prevalence of moderate to high nutritional risk identified by preoperative nutritional risk screening and clinical outcome in young children aged≤3 years with congenital heart disease(CHD),providing a basis for clinical nutrition support.Methods We enrolled 306 young children aged≤3 years with CHD receiving inpatient treatment in Guangdong General Hospital between June and December 2016 and screened nutritional risk in them preoperatively by using the nutritional risk screening tool STRONGkids.According to the results of screening,the CHD patients were divided into low-,moderate-,hign-nutritional risk groups.The clinical outcome was compared between those with moderate nutritional risk and those with high nutritional risk.Results Of the 306 cases,4(1.3%)were at low nutritional risk,134(43.8%)were at moderate nutritional risk,and 168(54.9%)were at high nutritional risk.Compared with those at moderate nutritional risk,young children at high nutritional risk had higher total medical cost,longer length of stay,longer duration of ICU stay,longer duration of mechanical ventilation,and higher incidence of postoperative infection(P<0.05),but these two groups showed no significant difference in the mortality(P>0.05).Conclusion Many of these young children were at high nutritional risk before the operation.Young children at high nutritional risk had higher total medical cost,longer length of stay,longer duration of ICU stay,longer duration of mechanical ventilation,and higher incidence of postoperative infection compared with those at moderate nutritional risk(P<0.05).

关 键 词：心脏病 遗传性疾病 先天性 儿童 营养状况 临床结局 

分 类 号：R596[医药卫生—内科学]