先天性心脏病新生儿围手术期营养支持的研究

发布时间：2018-08-09 07:02

【摘要】：目的 :通观察先天性心脏病新生儿术后早期阶段院内营养支持对病儿体重增加的影响。方法 :回顾性调查淮安市第一人民医院45例行姑息性手术的新生儿分别在手术时,从心脏外科监护室(CICU)转入普通病房时以及出院时的年龄别体重Z评分(WAZ评分)以及各个时间点的热卡摄入量(cal/kg/d)和总液体摄入量(ml/kg/d),我们同时调查了病儿开始肠内营养的时间及CICU住院时间(天数)。结果 :从接受姑息性分流手术时到出院时为止,总WAZ评分的中位数下降了-1.3[四分位数间距(IQR)-1.7到-0.7]。CICU住院时间5 d,开始肠内营养时间超过术后5天的病儿和病儿术后严重程度较高的病儿的WAZ评分变化差异明显(P0.001;P0.001;P=0.003)。结论 :现有的术后早期营养支持策略并不能满足病儿的能量需求;WAZ评分变化的关键影响因素为CICU住院时间,开始肠内营养的时间和病儿疾病的严重程度。
[Abstract]:Objective: to observe the effect of hospital nutrition support on weight gain of neonates with congenital heart disease. Methods: 45 neonates undergoing palliative operation in the first people's Hospital of Huaian City were investigated retrospectively. Age-specific weight Z score (WAZ score), heat calorie intake (cal/kg/d) and total fluid intake (ml/kg/d) at all time points when (CICU) was transferred from cardiac surgery unit to general ward and discharged from hospital. We also investigated the onset of enteral camp in children. The time of nursing and the length of CICU stay (days). Results: from the time of palliative shunt operation to the time of discharge, The median of total WAZ score decreased by -1.3 [quartile spacing (IQR) -1.7 to -0.7] .CICU hospitalization time was 5 days. The difference of WAZ score was significant between the children who started enteral nutrition longer than 5 days after operation and those who had higher severity after operation (P 0.001n P 0.001 P 0.003). Conclusion: the key factors influencing the changes of energy demand and CICU scores in the early postoperative nutrition support strategies are the duration of CICU hospitalization, the time of enteral nutrition and the severity of disease.
【作者单位】：南京医科大学附属儿童医院急诊重症医学科;淮安市第一人民医院心胸外科南京医科大学;
【基金】：南京医科大学科技发展基金面上项目(2016N JMU099)
【分类号】：R459.3;R722.1

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