学龄前先天性心脏病手术患儿523例营养评估及营养支持的研究

目的 评估先天性心脏病(先心病)患儿营养不良发生率,观察营养支持治疗的改善情况.方法 收集2008年1月～2008年12月我院收治的0～7岁先心病523例,依据年龄分为婴儿组(169例)、幼儿组(184例)及学龄前组(170例).于术前1d进行营养评估,术后予营养支持治疗并于术后8d再次进行营养评估.结果营养支持前,身长(高)实际值与标准值比较,婴儿组女性、幼儿组男性差异无统计学意义(P＞0.05),婴儿组男性、幼儿组女性及学龄前组男女身长(高)实际值均比标准值低,差异有统计学意义(P＜0.05).Z评分显示,营养支持前后低体重营养不良发生率和生长迟缓营养不良发生率差异均无统计学意义(P＞0.05).患儿术后呼吸机辅助治疗时间平均(6.54±2.58)h,并发症发生率为4.40％,病死率为0.96％.结论 先心病患儿存在不同程度的营养不良,与术后并发症发生率及病死率密切相关,而做好其营养评估并予个体化的营养支持是预后良好的保障.

Study of Nutritional Assessment and Support of 523 Pre-school Children after Congenital Heart Disease Operation

Objective To evaluate malnutrition rate in Pre-school children with CHD,and to observe the nutrition improvement after nutrition support.Methods 523 children aged 0-7 with HCD in the First Hospital of Hebei Medical University during January 2008 and December 2008 were selected.According to their ages,the CHD children were divided into three groups: infant group(n=169),kindergarden children group(n=184) and pre-school group(n=170).Nutrition assessment was done on the first day before operation and the eighth day postoperative,nutrition support was given postoperatively.Results Comparison of the height with the actual values and standard before nutrition support showed no significant difference with the girls in infant group and boys in kindergarden group,P>0.05.There was significant difference between the boys in infant group,girls in in kindergarden group and pre-school children,and the actual values of length were lower than the standard,P<0.05.Comparision of the weight with the actual values and standard showed no significant difference in girls of kindergarden group,P>0.05.The actual values of weight of babies,boys in kindergarden group and pre-school children were lower than the standard,with significant difference,P<0.05.The Z-score analysis showed that pre and post-nutrition support,there was no significant difference in low-weight malnutrition and slow-growth malnutrition,P>0.05.All CHD children were given hyperpnoea-aid treatment,the mean time was(6.54±2.58) h.The complication incidence rate was 47.11%.The fatality rate was 0.96%.Conclusion The CHD children suffer from different degrees of malnutrition,and it is closly related with the complication incidence rate and the fatality rate.Nutrition support and nutrition evaluation are important to reduce complications after operation.