摘要
目的了解不同能量喂养对PICU先天性心脏病患儿营养状态及临床转归的影响。方法选取2016年7月至2017年2月入住PICU的40例先天性心脏病患儿，随机分为高卡奶组和普通奶组，每组20例患儿，分别应用高卡蔼儿舒奶及普通蔼儿舒奶喂养，通过体格测量、实验室指标、营养风险筛查及静息能量消耗测定等进行营养状态研究，比较两组患儿喂养情况、营养状态、心功能情况及住院时间等指标。结果高卡奶组患儿出院时营养不良评估情况与入院时比较差异无统计学意义，普通奶组出院时中重度营养不良比例较入院时明显增高，两者之间比较差异具有统计学意义（ χ^2＝2.537，P＝0.042）。普通奶组患儿出院时中重度营养不良比例比高卡奶组高30%，但差异无统计学意义（χ^2＝0.860，P＝0.167），且两组患儿出院时营养风险筛查及心功能比较差异均无统计学意义。高卡奶组患儿出院时白蛋白及转铁蛋白均明显高于普通奶组（P均〈0.05）。高卡奶组能量供给及喂养适当病例数亦较普通奶组明显增加（P均〈0.05）。两组各9例行心脏手术，术前及术后机械通气时间比较无明显差异，术后发热时间高卡奶组低于普通奶组，差异具有统计学意义（t＝2.439，P＝0.027）。结论先天性心脏病患儿营养不良及喂养不足发生率高，营养风险比率高，在不增加心脏负荷的情况下，适当增加能量供应可以改善患儿营养不良状况及临床转归。
ObjectiveTo evaluate the effects of different energy feeding on the nutritional status,clinical course and outcome of children with congenital heart disease（CHD）in PICU.MethodsForty cases of hospitalized CHD children were selected as research objects from July 1,2016 to February 28,2017.They were randomly divided into two groups,one group（high-calorie milk group,n=20）were fed with high-calorie milk and the other（common milk group,n=20）were fed with common milk.The nutritional status of the two groups were calculated by physical measurements,laboratory indicators,nutrition risk screening and resting energy expenditure.This research also calculated the liquid and energy per day,compared their actual feeding situation,assessed their nutritional status and cardiac function at discharge,and compared the hospital stay,preoperative and postoperative mechanical ventilation time and postoperative fever time.ResultsThere was no statistical difference in the assessment of malnutrition during the discharge of high-calorie milk group.In common milk group,the proportion of moderate to severe malnutrition of discharge was significantly higher than that of admission（χ^2=2.537,P=0.042）.The proportion of moderate to severe malnutrition was great higher in common milk group than that in high-calorie milk group,but there was no statistical difference,and neither in nutritional risk screening nor cardiac function between the two groups at discharge.Albumin and transferrin of high-calorie milk group were significantly higher than those of the common milk group（t=2.195,P=0.034;t=2.064,P=0.046）.Also the number of appropriate energy supply and feeding cases in the high-calorie group were higher than those in the common milk group（t=2.334,P=0.025;χ^2 =10.600,P=0.005）.Nine cases underwent cardiopulmonary operation in the two groups respectively.There was no statistical difference in the time of ventilatory support between the two groups before and after operation,but the fever time of high-calorie milk group was s
作者
韩玉
关文贺
王丽杰
Han Yu;Guan Wenhe;Wang Lijie(Department of Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang 110004, China)
出处
《中国小儿急救医学》
CAS
2018年第3期216-220,共5页
Chinese Pediatric Emergency Medicine
基金
2017NST项目临床营养科研合作（NST-FUND-2017-12）
关键词
先天性心脏病
营养不良
临床预后
热量
喂养
Congenital heart disease
Malnutrition
Clinical prognosis
Calorie
Feeding
