符合管饲喂养指征的脑性瘫痪患儿营养干预的回顾性研究  

A retrospective study of nutritional interventions in children with cerebral palsy who meet the indications for tubefeeding

作　　者：张利红[1] 史凯丽 陈功勋 王瑞霞[1] 程志伟 朱登纳[1,3,4] Zhang Lihong;Shi Kaili;Chen Gongxun;Wang Ruixia;Cheng Zhiwei;Zhu Dengna(Children's Rehabilitation Hospital,the Third Afiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Medical Records Management,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Henan Pediatric Clinical Research Center.Zhengzhou 450052,China;Henan Key laboratory of Child Brain Injury,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院儿童康复医院,郑州450052 [2]郑州大学第三附属医院病案管理科,郑州450052 [3]河南省儿科疾病临床医学研究中心,郑州450052 [4]河南省小儿脑损伤重点实验室,郑州450052

出　　处：《中华实用儿科临床杂志》2025年第3期201-206,共6页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的对符合管饲喂养指征的脑性瘫痪(脑瘫)合并营养不良患儿在经口喂养和管饲喂养干预下, 观察营养指标及临床并发症、呼吸道感染改善情况。方法回顾性队列研究。选取2022年1月至2024年4月在郑州大学第三附属医院儿童康复医院住院的符合管饲喂养指征的脑瘫合并营养不良患儿82例, 分为经口喂养组和管饲喂养组, 应用t检验或Mann-WhitneyU检验或Kruskal-Wallis检验等分析2组干预前后年龄别体重Z评分(WAZ)、年龄别身高/身长Z评分(HAZ)及身高/身长别体重Z评分(WHZ)等营养指标及临床并发症和呼吸道感染改善情况。结果营养干预后3个月, 经口喂养组60例, 管饲喂养组22例, 管饲喂养组WHZ[-0.23(-1.79, 0.88)]改善优于经口喂养组[-1.62(-2.02, -0.91)](P<0.05);营养干预后6个月, 经口喂养组50例, 管饲喂养组16例, 管饲喂养组WAZ[-0.80(-1.92, -0.42)比-2.26(-2.88, -1.84)]、HAZ(-1.31±1.23比-2.32±1.19)、WHZ(-0.74±1.39比-1.58±1.03)改善均优于经口喂养组(均P<0.05);营养干预后12个月, 经口喂养组30例, 管饲喂养组10例, 管饲喂养组WAZ[-1.06(-1.77, -0.88)比-2.25(-3.06, -1.47)]、HAZ(-1.22±1.63比-2.54±1.50)改善均优于经口喂养组(均P<0.05)。管饲喂养组临床并发症改善情况优于经口喂养组, 管饲喂养组中呛咳(χ^(2)=16.29, P=0.001)、呕吐(χ^(2)=6.81, P=0.013)在营养干预前后比较差异有统计学意义。2组下呼吸道感染次数在营养干预后3个月、6个月差异均有统计学意义(均P<0.05)。结论在符合管饲喂养指征的脑瘫患儿中, 与经口喂养相比, 管饲喂养能更有效地优化临床营养指标, 降低各类临床并发症的发生率以及呼吸道感染的风险。Objective:To investigate the improvement in nutritional indicators,clinical complications,and respiratory infections among children with cerebral palsy(CP)and malnutrition who meet the indications for tube feeding under oral feeding and tube feeding interventions.Methods:In this retrospective cohort study,82 children with CP and malnutrition that met the indications for tube feeding from the Children′s Rehabilitation Hospital of the Third Affiliated Hospital of Zhengzhou University from January 2022 to April 2024 were included.These patients were divided into an oral feeding group and a tube feeding group.The t-test,Mann-Whitney U test,or Kruskal-Wallis test was used to analyze nutritional indices such as weight-for-age Z-score(WAZ),height/length-for-age Z-score(HAZ),and weight-for-height/length Z-score(WHZ)before and after intervention in both groups.The improvement in clinical complications and respiratory infections was also analyzed.Results:After 3-month nutritional intervention,there were 60 cases in the oral feeding group and 22 cases in the tube feeding group.The tube feeding group showed better improvement in WHZ[-0.23(-1.79,0.88)vs.-1.62(-2.02,-0.91)]than the oral feeding group(P<0.05).After 6-month nutritional intervention,there were 50 cases in the oral feeding group and 16 cases in the tube feeding group.The tube feeding group showed better improvement in WAZ[-0.80(-1.92,-0.42)vs.-2.26(-2.88,-1.84)],HAZ(-1.31±1.23 vs.-2.32±1.19),and WHZ(-0.74±1.39 vs.-1.58±1.03)than the oral feeding group(all P<0.05).After 12-month nutritional intervention,there were 30 cases in the oral feeding group and 10 cases in the tube feeding group.The tube feeding group showed better improvement in WAZ[-1.06(-1.77,-0.88)vs.-2.25(-3.06,-1.47)]and HAZ(-1.22±1.63 vs.-2.54±1.50)than the oral feeding group(all P<0.05).Clinical complications improved better in the tube feeding group than those in the oral feeding group.In the tube feeding group,significant differences in choking(χ^(2)=16.29,P=0.001)and vomiting(χ^(2)=6.81

关 键 词：脑性瘫痪 营养不良 经口喂养 管饲喂养 

分 类 号：R47[医药卫生—护理学]