25例婴儿肉毒中毒营养管理状况分析  

Analysis on nutritional management status in 25 cases of infant botulism

作　　者：王丽娟[1] 吴鑫宇 钱素云[1] 贾鑫磊[1] 王荃[1] 樊超男[1] Wang Lijuan;Wu Xinyu;Qian Suyun;Jia Xinlei;Wang Quan;Fan Chaonan(Department of Pediatric Intensive Care Unit,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院重症医学科,100045

出　　处：《中国小儿急救医学》2025年第4期297-300,共4页Chinese Pediatric Emergency Medicine

基　　金：白求恩公益基金。

摘　　要：目的分析肉毒中毒婴儿营养不良的临床特点及营养治疗概况。方法回顾性收集2019年5月1日至2024年10月31日首都医科大学附属北京儿童医院收治的25例肉毒中毒婴儿营养风险及营养不良的发生情况,分析其营养治疗方式、制剂、耐受情况、能量摄入率、继发感染及预后等。结果共纳入25例患儿,男19例、女6例,中位年龄5(4,6)月龄。25例均表现出进食减少,入院时中位体重为7.3(7.0,9.0)kg。营养评估筛查高风险24例(96%),1例营养不良。24例(96%)接受了鼻胃管喂养,早期肠内营养实施率为84%(21例),间断喂养25例(100%)。14例使用整蛋白配方奶,8例使用水解蛋白配方奶,3例给予5%含糖液。9例启用静脉营养,持续时间为9(5,12)d。5例发生肠内营养喂养不耐受,均发生继发感染并启用静脉营养。25例患儿均好转出院,出院时17例(68%)经口喂养,8例(32%)经鼻胃管喂养,出院时中位体重7.5(7.0,9.0)kg,15例(60%)体重增加,出院时营养风险筛查评估均为低风险。结论肉毒中毒婴儿入院时多处于营养高风险状态,早期胃管置管和肠内营养治疗实施率高,部分患儿可发生喂养不耐受,配合适时启用肠外营养替代及对症处理可改善预后。Objective To analyze the clinical characteristics and nutritional treatment of malnutrition in infants with botulism.Methods A retrospective analysis was conducted on 25 infant botulism patients admitted to Beijing Children's Hospital Affiliated to Capital Medical University,from May 1,2019 to October 31,2024.The nutritional risk and malnutrition incidence were assessed,nutritional therapy methods,formulations,tolerance status,energy intake rate,secondary infections and prognosis were analyzed.Results A total of 25 pediatric patients were included,19 males and 6 females,with a median age of 5(4,6)months.Twenty-five cases(100%)showed reduced food intake,with a weight of 7.3(7.0,9.0)kg upon admission.Twenty-four cases(96%)were assessed as high-risk for nutrition screening,and one case was diagnosed with malnutrition.Twenty-four cases(96%)received nasogastric tube feeding,with an early enteral nutrition implementation rate of 84%(21 cases)and intermittent infusion in 25 cases(100%).Fourteen cases used whole protein formula milk,eight cases used hydrolyzed protein formula milk and three cases were given 5%sugar solution.Nine cases were treated with intravenous nutrition,with a duration of 9(5,12)days.Five cases(20%)developed enteral feeding intolerance,and all five cases had secondary infections and were treated with parenteral nutrition.All 25 patients had good prognosis.At discharge,17 cases(68%)were fed orally,and eight cases(32%)were fed through nasogastric tubes,with a median weight of 7.5(7.0,9.0)kg.Fifteen patients(60%)had weight gain,and the nutritional screening assessment was all low-risk.Conclusion Infants with botulism are mostly in a state of high nutritional risk when they are admitted to hospital.Early enteral nutrition through a gastric tube has a high implementation rate.Some children may experience feeding intolerance,combined with timely use of parenteral nutrition replacement and symptomatic treatment can improve prognosis.

关 键 词：肉毒中毒 婴儿 营养治疗 营养风险 喂养不耐受 

分 类 号：R72[医药卫生—儿科]