住院营养不良儿童出院后营养恢复状况分析

Nutritional recovery after discharge in hospitalized children with malnutrition

摘要:

目的 了解住院期间存在中度、重度营养不良的儿童出院后营养恢复状况。方法 住院期间给予中度或重度营养不良的患儿营养支持治疗，并进行定期出院后随访及营养指导。以患儿年龄别体重及年龄别身高Z评分均 > ?-2?SD作为结束随访的营养目标。结果 入选中度或重度营养不良患儿共298名，其中174例（58.4%）达到结束随访标准，失访100例（33.6%），死亡18例（6.0%），随访18个月仍未达结束随访标准者6例（2.0%）。外科重度营养不良患儿中达到结束随访标准的比例高于内科（P < 0.05），重度营养不良患儿失访率高于中度营养不良患儿（P < 0.05）。消瘦患儿达到结束随访标准的高峰期为出院后3个月，生长迟缓患儿为出院后3~6个月。到出院后1年，各型营养不良患儿达到结束随访标准的比例均超过80%。结论 坚持随访的营养不良患儿大部分在出院后1年内可达到预期营养目标，生长迟缓患儿的营养恢复较消瘦患儿慢。

Abstract:

Objective To investigate the nutritional recovery status of children with moderate or severe malnutrition during hospitalization after discharge. Methods The children with moderate or severe malnutrition were given nutrition support during hospitalization. They received a regular follow-up and nutrition guidance after discharge. The weight-for-age and height-for-age Z-scores reaching above -2?SD were considered the nutrition criterion for ending follow-up. Results Among the 298 children with moderate or severe malnutrition, 174 (58.4%) reached the criterion for ending follow-up, 100 (33.6%) were lost to follow-up, 18 (6.0%) died, and 6 (2.0%) did not reach the criterion for ending follow-up after 18 months of follow-up. The children with malnutrition in the department of surgery had a significantly higher proportion of children reaching the criterion for ending follow-up than those in the department of internal medicine (P < 0.05). The children with severe malnutrition had a significantly higher loss to follow-up rate than those with moderate nutrition (P < 0.05). The majority of children with emaciation reached the criterion for ending follow-up at month 3 after discharge, while those with growth retardation reached such the criterion at months 3-6 after discharge. Up to 1 year after discharge, more than 80% of the children with different types of malnutrition reached the nutrition criterion for ending follow-up. Conclusions Most of the children with malnutrition who adhere to follow-up can reach the expected nutrition criterion within 1 year after discharge. The children with growth retardation have slower nutritional recovery than those with emaciation.