不同能量营养管理策略对先天性心脏病合并重症肺炎患儿营养状态及生长发育的影响

Effects of Different Energy and Nutrition Management Strategies on Nutritional Status and Growth in Children with Congenital Heart Disease Complicated by Severe Pneumonia

目的探讨不同能量营养管理策略对先天性心脏病合并重症肺炎患儿营养状态及生长发育的影响。方法选取河南省儿童医院2017年5月至2019年5月收治的先天性心脏病合并重症肺炎并行外科手术治疗且术前合并营养不良的患儿99例,根据喂养方法不同分为2组:对照组49例予以普通能量配方奶喂养,观察组50例予以高能量配方奶喂养,3个月后,比较2组营养状态[血清总蛋白(TP)、血清白蛋白(ALB)及血清前白蛋白(PA)水平]、生长发育情况(体质量、头围和肱三头肌皮褶厚度)及并发症发生率。结果与干预前比较,2组干预后TP、ALB及PA水平均显著升高,且观察组干预后上述各指标水平升高更为明显,差异有统计学意义(均P<0.05);与干预前比较,2组干预后体质量、头围和肱三头肌皮褶厚度均显著增加,且观察组干预后上述各指标增加更为明显,差异有统计学意义(均P<0.05);2组干预后并发症发生率比较,差异无统计学意义(P>0.05)。结论先天性心脏病合并重症肺炎患儿采用高能量配方奶喂养可在不增加负担的同时满足患儿营养需要,从而有效改善其营养不良状态,促进患儿生长发育,是一种安全有效的营养干预途径。

Objective To investigate the effects of different energy and nutrition management strategies on nutritional status and growth in children with congenital heart disease complicated by severe pneumonia.Methods A total of 99 children with congenital heart disease,severe pneumonia and preoperative malnutrition who were admitted to Henan Children’s Hospital between May 2017 and May 2019 and underwent surgical treatment were fed either ordinary energy formula(control group,n=49)or high-energy formula(observation group,n=50).After 3 months of intervention,serum levels of total protein(TP),serum albumin(ALB)and prealbumin(PA),body weight,head circumference,triceps skinfold thickness,and incidence of complications were compared between the two groups.Results After intervention,serum TP,ALB and PA levels,body weight,head circumference,and triceps skinfold thickness significantly increased in both groups,and the increase in the observation group was more obvious than that in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion As a safe and effective nutritional intervention way,high-energy formula can meet the nutritional needs of children without increasing the burden,thus effectively improving malnutrition and promoting growth and development in children with congenital heart disease complicated by severe pneumonia.