个体化营养管理在脑性瘫痪患儿中的应用

Individualized nutritional management for children with cerebral palsy

目的观察个体化营养管理对脑性瘫痪(简称脑瘫)患儿的影响。方法对37例脑瘫患儿建立营养管理档案及综合营养评价,进行为期3个月的个体化营养干预治疗,比较营养干预治疗前后年龄别身长(HAZ)、身长别体质量(WHZ)、年龄别体质量(WAZ)、年龄别体质量指数(BMIZ)等测量指标。结果 37例患儿中消瘦率为43%,生长迟缓率为38%,低体质量率为30%。根据WHZ值将患儿分为营养良好组、轻度营养不良组及中-重度营养不良组。干预治疗后,营养良好组WHZ(0.4±0.8)及BMIZ(0.6±0.8)均较治疗前提高,差异有统计学意义(P<0.05);轻度营养不良组及中-重度营养不良组WHZ(-0.8±0.6;-1.5±1.0)、WAZ(-1.6±0.9;-2.4±1.0)及BMIZ(-0.7±0.7;-1.1±0.9)均较治疗前提高,差异均有统计学意义(P<0.05)。结论营养不良在脑瘫患儿中发生率高,个体化营养干预治疗可有效改善其近期营养状况。

Objective To explore the effects of individualized nutritional management on children with cerebral palsy. Methods Nutrition management files were set up and the synthetic nutrition was evaluated in 37 children with cerebral palsy, who received individualized intervention for 3 months. Weight-for-length z score（WHZ） ,length-for-age z score（HAZ）, weight-for-age z score（WAZ）, and body mass index-for-age z score（BMIZ） after the intervention were compared with those before the treatment. Results Among 37 cases,emaciation was in 43% of them,growth retardation 38% and low weight 30%. According to WHZ,all the children were divided into three groups：normal nutrition group, mild malnutrition group and moderatesevere malnutrition group. After the individualized nutritional intervention,WHZ（0.4 ：[： 0.8）and BMIZ（0.6 ±0. 8）in normal nutrition group were significantly improved（P〈0. 05）;WHZ（- 0. 8 ± 0. 6; -1.5 ± 1.0）, WAZ（-1.6±0.9;-2.4±1.0） and BMIZ（-0. 7±0. 7;-1.1±0. 9） in mild malnutrition group and moderate-severe malnutrition group were also improved（P〈0.05）o Conclusion There is high incidence of malnutrition in children with cerebral palsy; individualized nutritional management can effectively improve the nutritional status in the short term.