脑瘫患儿营养支持及肠内营养配方选择算法

O. Titova, N. Taran, A. V. Keleinikova, M. Shavkina, E. Pavlovskaya, T. Strokova
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引用次数: 0

摘要

目标。研究一种基于营养状况指标和伴随病理性质的脑瘫患儿营养支持/肠内营养产品选择算法。患者和方法。本研究包括261名2至17岁的儿童(159名(61%)男孩)诊断为痉挛性脑瘫。根据大运动功能测量(GMFM)水平和喂养方式(每os /胃造口)将所有儿童分为不同的组。调查营养状况和胃肠道症状特征,并评估实际营养状况。通过测量肱三头肌皮褶厚度和中上臂围来评估身体组成。考虑到确定的营养状况和胃肠功能紊乱,对饮食进行调整。随访6-9个月,评估饮食治疗的效果。结果。在40-79%的病例中检测到体重不足,最常见于GMFCS水平的IV、V、VTF组:分别有14例(21.9%)、33例(40.7%)和18例(39.1%)儿童(pVTF-V-IV < 0.001)。IV组、V组和VTF组记录发育迟缓。最常见的胃肠道疾病是便秘(47.1%)。213名(81.6%)儿童登记为能量缺乏,比正常水平高出12.3-61.8%。宏量营养素缺乏率:蛋白质- 11.4-60.0%,脂肪- 10.9-61.6%,碳水化合物- 20.3-72.6%,低于个人标准/推荐膳食摄入量。在随访期间,在饮食治疗的背景下,观察到体重和身高指标有统计学意义的积极动态,脂肪量和骨骼肌量增加,胃肠道症状缓解。对研究结果的分析使我们能够开发出一种为脑瘫儿童选择营养支持/肠内营养产品的算法。结论。对脑瘫患者营养状况的评估和营养失调的纠正需要综合的方法。在1-3个月后没有积极的动力,有必要修改饮食方案。关键词:饮食治疗算法,脑瘫,运动水平,体重不足,营养支持
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Algorithm of formula selection for nutritional support and enteral nutrition in children with cerebral palsy
Objective. To develop an algorithm for selecting a nutritional support / enteral nutrition product in children with cerebral palsy based on nutritional status indicators and the nature of concomitant pathology. Patients and methods. This study included 261 children aged 2 to 17 years (159 (61%) boys) diagnosed with spastic cerebral palsy. All children were divided into different groups according to the Gross Motor Function Measure (GMFM) level and feeding method (per os / gastrostomy). Nutritional status and characteristics of gastrointestinal symptoms were investigated, and actual nutrition was assessed. Body composition was evaluated by measuring triceps skinfold thickness and mid-upper arm circumference. Dietary adjustments were made considering the identified disorders of nutritional status and gastrointestinal function. Follow-up examination was performed after 6–9 months to assess the efficacy of diet therapy. Results. An underweight condition was detected in 40–79% of cases and was most frequently observed in groups IV, V, VTF of GMFCS levels: 14 (21.9%), 33 (40.7%) and 18 (39.1%) children, respectively (pVTF–V–IV < 0,001). Stunting was recorded in groups IV, V, and VTF. The most common gastrointestinal disorder was constipation (47.1%). Energy deficiency was registered in 213 (81.6%) children and amounted to 12.3–61.8% from the norm. The rate of macronutrient deficiency: protein – 11.4–60.0%, fats – 10.9–61.6%, carbohydrates – 20.3–72.6% from the individual norm / recommended dietary intake. In the follow-up period, statistically significant positive dynamics of weight and height indicators, an increase in fat mass and skeletal muscle mass, and relief of gastrointestinal manifestations were observed against the background of diet therapy. Analysis of findings allowed us to develop an algorithm for selecting a nutritional support / enteral nutrition product for children with cerebral palsy. Conclusion. Evaluation of nutritional status and correction of its disorders requires a comprehensive approach in patients with cerebral palsy. In the absence of positive dynamics after 1–3 months, it is necessary to revise a dietary regimen. Key words: diet therapy algorithm, cerebral palsy, motor activity level, underweight, nutritional support
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来源期刊
Voprosy Detskoi Dietologii
Voprosy Detskoi Dietologii Medicine-Pediatrics, Perinatology and Child Health
CiteScore
1.20
自引率
0.00%
发文量
17
期刊介绍: The scientific journal Voprosy Detskoi Dietologii is included in the Scopus database. Publisher country is RU. The main subject areas of published articles are Food Science, Pediatrics, Perinatology, and Child Health, Nutrition and Dietetics, Клиническая медицина.
期刊最新文献
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