重庆市0～4岁儿童便秘与膳食纤维摄入调查

发布时间：2018-05-03 08:04

本文选题：儿童 + 大便分型　；参考：《重庆医科大学》2014年硕士论文

【摘要】：第一部分0～4岁社区儿童便秘调查目的了解0～4岁儿童便秘情况。方法以重庆市渝中区大溪沟社区卫生服务中心管辖的2010年1月-2013年12月出生的0～4岁儿童作为研究对象。采用现场发放问卷及电话问询填写问卷两种方式调查儿童的大便情况。家长按Bristol大便分型图报告儿童大便性状，便秘诊断依据罗马III标准。Bristol大便分型1～3型结合罗马III主要诊断项后计算敏感度、特异度、阳性似然比和阴性似然比。结果该社区共有0～4岁儿童1206例，发放问卷1050份，回收问卷1000份，有效问卷972份。调查参与率87.1%（1050/1206），问卷有效率97.2%（972/1000）。家长按Bristol大便分型图报告儿童大便1～3型者120例（12.3%120/972），61.5%(598/972)的儿童大便为4型，5-7型者为26.1%。本文调查资料符合便秘诊断儿童55例，患病率5.6（55/972）的大便外型均为Bristol大便分型的1～3型；发生便秘儿童无明显性别差异（X2=0.157，p0.05）；13例婴儿发生便秘（5.4%，13/240），幼儿23例（6.1%，23/374），学龄前儿童19例（10.8%，19/205）。Bristol大便形状1~3型分别与“每周排便2次及以下”和“排便疼痛或排便困难史”组合后诊断便秘的敏感度均为100%，特异度96.8%以上，前者阳性似然比高于后者(142.9v31.3)。结论小婴儿以6型便为主，随年龄增长，0～4岁儿童逐渐过渡到以4型便为主；0～4岁儿童便秘患病率为5.6%；无明显性别差异；儿童大便性状与饮食有关；罗马III结合Bristol大便形状1~3型可更直观地诊断儿童便秘，大便外型1～3型的儿童是便秘发生的高危儿。第二部分便秘儿童膳食纤维摄入状况调查目的了解便秘儿童膳食纤维摄入情况。方法6月龄-4岁便秘儿童为研究对象，采用72小时称重法进行儿童膳食调查，计算儿童膳食纤维摄入量，与正常儿童对照。随访部分儿童便秘症状改善情况，并再次进行72小时称重法膳食调查，，自身对照便秘改善后膳食纤维摄入情况。应用营养软件对儿童膳食营养成分进行分析。结果本文纳入70例6月龄-4岁便秘儿童，其中50例（71.4%，50/70）便秘儿童家长同意进行膳食调查，其中22例（44%）儿童家长完成二次膳食调查。同时完成35例6月龄-4岁正常儿童膳食调查。便秘婴儿DF平均摄入量为1.2g/d，低于同龄正常婴儿4.0g/d。1-4岁便秘组儿童DF摄入量平均为3.9g/d，显著低于同龄正常儿童DF摄入量5.9g/d(p㩳0.05)。所有22例便秘缓解儿童第二次膳食分析结果均显示膳食纤维摄入量明显增高。结论便秘儿童膳食纤维摄取量低于正常儿童，增加纤维素摄入量可改善便秘。大部分正常儿童膳食纤维摄入量均低于AHF、FDA及NAS等推荐量标准，需要进一步研究儿童DF摄入量和推荐量。
[Abstract]:Part I investigation on constipation of children aged 4 years old in community Objective to investigate the constipation of 0-year-old children. Methods the 4-year-old children born from January 2010 to December 2013 in Daxigou Community Health Service Center in Yuzhong District of Chongqing City were used as the research objects. The defecation of children was investigated by field questionnaire and telephone questionnaire. According to Bristol stool typing pattern, parents reported stool traits of children. Constipation diagnosis was based on Roman III standard. Bristol stool typing 1 / 3 combined with Roman III main diagnostic items to calculate sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Results there were 1206 children aged 4 years old in this community, 1050 questionnaires were sent out, 1000 questionnaires were collected, and 972 valid questionnaires were obtained. The rate of participation in the survey was 87.1% 1050 / 1206, and the efficiency of the questionnaire was 97.2and 972 / 1000. According to the Bristol stool typing chart, 120 cases of children's defecation type 1 / 3 were reported as 26.1in 12.3 / 97 / 61.5 / 598 / 972) children's defecation type 4 / 5-7. According to the data of 55 children with constipation, the prevalence rate of 5. 6% to 55% 972) was found to be 1 / 3 type of Bristol stool typing. There is no significant gender difference in children with constipation: X _ 2 / 0.157 / p _ (0.05) / 13 / 13 / 240, 23 / 3 / 374, 19 / 10.8 / 19205n 路Bristol respectively with "defecation twice a week or less" and "defecation pain or defecation history" The sensitivity of post-diagnosis of constipation was 100 and the specificity was above 96.8%. The positive likelihood ratio of the former was higher than that of the latter. Conclusion the prevalence rate of constipation in children aged from 4 years old to 4 years old is 5.6, there is no significant difference in sex, and the defecation traits of children are related to diet. Roman III combined with Bristol stool shape 1 / 3 can be used to diagnose constipation in children more intuitively. Children with 1 / 3 type of defecation are at high risk of constipation. Investigation on dietary fiber intake of constipation children Objective to investigate dietary fiber intake in constipation children. Methods Children aged from 6 months to 4 years old with constipation were investigated with 72 hour weighing method. Dietary fiber intake of children was calculated and compared with that of normal children. The symptoms of constipation were improved in some children, and the dietary fiber intake after 72 hours weighing was investigated again, compared with the improvement of constipation. Nutrition software was used to analyze the nutritional composition of children's diet. Results A total of 70 children aged 6 months to 4 years of age were included in this study. Among them, 50 cases (71.4% 50 / 70) agreed to carry out a dietary survey, of which 22 cases (44 cases) completed a second dietary survey. At the same time, 35 cases of normal children aged 6 months to 4 years old were investigated. The average DF intake of constipation infants was 1.2 g / d, which was significantly lower than that of normal infants aged 4.0g/d.1-4 years (3.9 g / d) and 5.9 g / d of constipation infants (5.9g / d 路d ~ (-1) 路d ~ (-1), significantly lower than that of normal children of the same age (5.9 g 路d ~ (-1) 路d ~ (-1). The results of the second dietary analysis of 22 children with constipation relief showed that dietary fiber intake was significantly increased. Conclusion the dietary fiber intake of constipation children is lower than that of normal children. The dietary fiber intake of most normal children was lower than that of AHF FDAD and NAS, so it was necessary to study the dietary fiber intake and recommended amount of DF in children.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.7

【共引文献】