儿童单纯肥胖症门诊治疗效果观察

Outpatient Treatment Program for Obese Children.

【目的】 观察门诊治疗肥胖儿童的可行性及治疗效果。 【方法】 以WHO身高标准体重值为肥胖判断标准。自 1997年 12月～ 1999年 8月共治疗单纯性肥胖儿童 15 8例 ,治疗方法为控制饮食、改变饮食行为、中等程度 (心率 14 5～ 15 5次 /分 )有氧运动、减少静坐时间、健康教育等 ,首诊制订一周治疗方案 ,每周复诊 1次 ,根据患儿对治疗方案的执行情况制订下 1周治疗计划。采用个案分析方法 ,对不同年龄、不同肥胖度及是否有合并症等设定不同的治疗目标。 【结果】 治疗时间少于 4周者 98例 ,治疗时间在 4周及以上者 160例 (分别占就诊人数的 3 7.9%和62 .1% )。上述 160例肥胖儿童中 ,治疗后体重下降者 12 7例 ,减重幅度为 0 .5～ 7.5kg ,平均减重 (3 .5± 2 .9)kg ,体重不变或上升者 3 3例 ;体块指数 (bodymassindexBMI)下降者 15 8例 ,下降幅度为 0 .2～ 5 .6,平均下降 (1.8± 1.1)。BMI值不变者 2例。治疗时间较长者 (9周以上 )治疗效果较好。 【结论】 在门诊对肥胖儿童使用包括饮食调整、有氧运动。

Objective To design an outpatient treatment program for obese children and to investigate the feasibility and effect. Methods 258 obese children(112 boys and 146 girls,average age:(10.5±1.8)y,range 6～16y,average body mass index:26.7kg/m 2,range(22.3～32.4). were involved in our outpatient treatment program including change eating and lifestyle,resistance exercise(HR 145～155 beat per minute)reducing sedentary behavior and nutrition education.Anthropometrical dates were obtained at the first visit and every week visit.The use of weight maintenance versus weight loss to achieve weight goals depends on each obese child's age,obese degree,and presence of medical complications. Results 98 obese children were treated less than 4 weeks and 160 obese children were treated 4 weeks or more.Among the 160 obese children,127 loss their weight,average 3.5kg,range 0.5～7.5kg.158 had a decrease of body mass index(BMI),average 1.8,range 0.2～5.6.Significantly better outcome were obtained when 9 weeks or more of treatment occurred for the 160 obese children. Conclusions The outpatient treatment program that including reductions in high-fat and high calorie foods,changing the child's eating habits,moderate exercise and nutrition education was feasibility and effective for obese children.