摘要
目的 :通观察先天性心脏病新生儿术后早期阶段院内营养支持对病儿体重增加的影响。方法 :回顾性调查淮安市第一人民医院45例行姑息性手术的新生儿分别在手术时,从心脏外科监护室(CICU)转入普通病房时以及出院时的年龄别体重Z评分(WAZ评分)以及各个时间点的热卡摄入量(cal/kg/d)和总液体摄入量(ml/kg/d),我们同时调查了病儿开始肠内营养的时间及CICU住院时间(天数)。结果 :从接受姑息性分流手术时到出院时为止,总WAZ评分的中位数下降了-1.3[四分位数间距(IQR)-1.7到-0.7]。CICU住院时间>5 d,开始肠内营养时间超过术后5天的病儿和病儿术后严重程度较高的病儿的WAZ评分变化差异明显(P<0.001;P<0.001;P=0.003)。结论 :现有的术后早期营养支持策略并不能满足病儿的能量需求;WAZ评分变化的关键影响因素为CICU住院时间,开始肠内营养的时间和病儿疾病的严重程度。
Objective： To investigate the impact of hospital-based nutritional practices on weight gain in neonates during the immediate postoperative period. Methods： It is a retrospective study of 45 neonates who underwent modified systemic-to-pulmonary artery shunt in Huai＇ an First People＇ s Hospital. We reviewed the weight-for-age Z-score （WAZ score） at the time points of the date of surgery, transfer from cardiac intensive care unit （CICU） to general ward, and day of hospital discharge. Caloric intake （calories/kg/day） and total fluid intake （ml/kg/day） at different time points were measured too. We also reviewed the initiation time of enteral feeding and CICU stay （days） postoperatively. Results： An overall median WAZ score decrease of- 1.3 （IQR -1.7 to -0.7） from time of shunt palliation to hospital discharge. A length of stay of 〉5 days in the CICU, initiation of enteral feeding beyond the postoperative days （POD） 5 and the severity of diseases were significantly associated with a great mean difference in WAZ score（P 〈 0.001, P 〈 0.001, P = 0.003）. Conclusion： The nutrition support in immediate postoperative period is substantially lower than what is needed; initiation time of enteral feeding, a length of stay 〉 5 days in the CICU and the severity of diseases were independent predictors of a greater change in WAZ score.
出处
《肠外与肠内营养》
北大核心
2017年第6期365-368,373,共5页
Parenteral & Enteral Nutrition
基金
南京医科大学科技发展基金面上项目(2016N JMU099)
关键词
先天性心脏病
营养
分流术
热卡摄入
生长障碍
Congenital heart disease
Nutrition
Shunts
Caloric intake
Growth failure
