精神合并症对儿童和青少年限制性进食障碍患者强制鼻胃管喂养时间的影响

S. Fuller, P. Falcoski, L. Hudson, Jacinta Tan
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摘要

作者的临床经验发现,一些患者需要强制鼻胃管喂养的干预时间明显长于其他患者。本研究的目的是确定不同的精神合并症是否与限制进食障碍儿童和青少年的鼻胃管进食的不同持续时间有关。2018年进行了回顾性病例分析。从电子病历和医院事件表中收集数据,重点关注诊断、住院时间和限制下鼻胃管喂养的发作次数。共有9例患者需要在约束下进行鼻胃管喂养,其中4例患者存在精神合并症(新发情绪不稳定型人格障碍、自闭症谱系障碍和复杂创伤)。精神合并症患者的住院时间没有显著增加(中位数=302天vs 241天,Mann-Witney U=16.00, P=0.20)。然而,在有精神合并症的患者中,限制鼻胃管喂养的发作次数明显高于无精神合并症的患者(中位数=31.00 vs 2次,Mann-Whitney U=20.00, P=0.02)。本研究提示,精神疾病合并症与限制下鼻胃管喂养的发作时间延长有关,因此患有这些合并症的患者将有更大的治疗计划需求。
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The influence of psychiatric comorbidities on the duration of compulsory nasogastric tube feeding of children and adolescents with restrictive eating disorders
The authors' clinical experience found that some patients required the intervention of compulsory nasogastric tube feeding for a significantly longer amount of time than others. The aim of this study was to identify whether different psychiatric comorbidities are associated with different durations of nasogastric tube feeding under restraint in children and young people with restrictive eating disorders. A retrospective case-note analysis was conducted in 2018. Data were collected from electronic medical records and hospital incident forms, focusing on diagnosis, length of stay and on the number of episodes of nasogastric tube feeding under restraint. A total of nine patients required nasogastric tube feeding under restraint, of which four patients had psychiatric comorbidities (emerging emotionally unstable personality disorder, autism spectrum disorder and complex trauma). Length of stay was not significantly greater in patients with psychiatric comorbidities (median=302 vs 241 days, Mann-Witney U=16.00, P=0.20). However, the number of episodes of nasogastric tube feeding under restraint was significantly greater in those with psychiatric comorbidities (median=31.00 vs 2 episodes, Mann-Whitney U=20.00, P=0.02) than those without. This study suggests that psychiatric comorbidities are associated with more prolonged episodes of nasogastric tube feeding under restraint and therefore patients with these comorbidities will have greater treatment planning needs.
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