高校学生神经性厌食症的中医辨治

神经性厌食症是进食紊乱的一种类型，青少年发病率较高。由于这一患病群体正处在身心发育和完成学业的关键时期，治疗效果如何，将关系到他们终生的身心健康。笔于2000年5月-2003年6月采用“解郁健脾汤”治疗患40例，疗效满意，现报道如下。     

解读神经性厌食症

今年8月22日夜里．湖南岳阳市四中的15岁女孩曾依。在北京世纪坛医院离开了人世．死因是过度饥饿导致多脏器衰竭。15岁的花季年龄死干神经性厌食症．令人同情．发人深思!     

摄食障碍7例临床分析

本文报告17例摄食障碍患者的临床资料。笔者结合文献，从摄食障碍的概念、发病率、病因，以及与情感性精神障碍的关系和治疗等方面加以讨论。     

小儿厌食症的临床治疗研究

目的探讨小儿厌食症的发病原因及最佳治疗方法。方法我院儿科门诊2007年1月1日至2007年6月1日收治厌食症患几184例，针对不同个体进行全面综合分析，找出诱因，对症治疗。结果97．8％以上的患儿食欲增加，生长发育恢复正常。结论家长强迫进食这种不良喂养方式和进食习惯是导致小儿厌食症的主要原因，合理的喂养方法，必要的药物治疗是解决小儿厌食症的最佳途径。     

女孩患上神经性厌食症

婷婷是个14岁的女孩,从小活泼可爱,能歌善舞,是父母的“掌上明珠”,父母对她娇生惯养,倍加溺爱。上中学后,看到影星、舞星、时装模特,个个身材苗条,楚楚动人,羡慕不已。于是希望有朝一日,自己也能成为一个令人羡慕的“明星”。半年前,在一次班级联欢会上,婷婷一展舞姿,优美动人,博得同学们的喝彩。但不     

神经性厌食的心理护理

目的报告50倒神经性厌食患的心理护理体会，主要心理护理措施包括建立良好的护患关系，共同确定目标体重，制定合理的食谱运用认知治疗及心理分析治疗。     

以低钾血症起病的神经性厌食症探讨分析

目的:探讨易于漏诊的表现为低钾血症的神经性厌食症患者的临床特点。方法:对我院2003年-2010年以低钾血症原因待查入院而最终诊断为神经性厌食症的4例患者临床资料进行回顾性分析。结果:4例患者体形消瘦,BMI在12.5 kg/m2～16.4 kg/m2之间,体温、血压均偏低,血钾水平变化无规律,均经反复询问病史与仔细观察后获得关键病史得以诊断。结论:对于血钾水平无规律的重度消瘦患者,需要考虑神经性厌食症的可能。     

Long-term Outcomes of Adolescent Anorexia Nervosa on Bone

Purpose

Anorexia nervosa (AN) is a chronic and life-threatening eating disorder that can have a considerable negative impact on the growing skeleton. We hypothesized that the long-term impact on bone health may persist even after normalization of body weight.

A Prospective Examination of Weight Gain in Hospitalized Adolescents With Anorexia Nervosa on a Recommended Refeeding Protocol

Purpose

Current refeeding recommendations for adolescents hospitalized with anorexia nervosa (AN) are conservative, starting with low calories and advancing slowly to avoid refeeding syndrome. The purpose of this study was to examine weight change and clinical outcomes in hospitalized adolescents with AN on a recommended refeeding protocol.

Methods

Adolescents aged 13.1-20.5 years were followed during hospitalization for AN. Weight, vital signs, electrolytes, and 24-hour fluid balance were measured daily. Percent median body mass index (%MBMI) was calculated as 50th percentile BMI for age and gender. Calories were prescribed on admission and were increased every other day.

Results

Thirty-five subjects with a mean (SD) age of 16.2 (1.9) years participated over 16.7 (6.4) days. Calories increased from 1,205 (289) to 2,668 (387). No subjects had refeeding syndrome; 20% had low serum phosphorus. Percent MBMI increased from 80.1 (11.5) to 84.5 (9.6); overall gain was 2.10 (1.98) kg. However, 83% of subjects initially lost weight. Mean %MBMI did not increase significantly until day 8. Higher calories prescribed at baseline were significantly associated with faster weight gain (p = .003) and shorter hospital stay (p = .030) in multivariate regression models adjusted for %MBMI and lowest heart rate on admission.

Conclusions

Hospitalized adolescents with AN demonstrated initial weight loss and slow weight gain on a recommended refeeding protocol. Higher calorie diets instituted at admission predicted faster weight gain and shorter hospital stay. These findings support the development of more aggressive feeding strategies in adolescents hospitalized with AN. Further research is needed to identify caloric and supplementation regimens to maximize weight gain safely while avoiding refeeding syndrome.     

The COVID-19 Pandemic and Canadian Pediatric Tertiary Care Hospitalizations for Anorexia Nervosa

PurposeGlobal studies show an increase in hospitalizations for pediatric eating disorders (EDs). No published Canadian studies have confirmed these findings in pediatric ED programs for one-year post onset of the COVID-19 pandemic. The primary objective was to examine health administrative data from two pediatric tertiary care ED programs: Alberta Children's Hospital (ACH) and Hospital for Sick Children (SickKids) to determine the number of pediatric hospitalizations with the most responsible discharge diagnosis of anorexia nervosa (AN).MethodsThis hospital-based design explored monthly pediatric hospitalizations in seven-year-olds to 18-year-olds between March 11, 2014 and March 11, 2021 using the Discharge Abstract databases. The analysis used negative binomial regression with robust standard errors to compare hospitalization counts in the months preceding and following the World Health Organization pandemic declaration (March 11, 2020).ResultsHospitalizations due to pediatric AN increased by 63% and 132% at SickKids (p < .001) and ACH (p < .001), respectively, in the first year of the pandemic compared to the previous six years. The total number of non-ED hospitalizations decreased by 29.3% and 2.4% at SickKids and ACH, respectively.DiscussionThis is the first Canadian study to show a rise in pediatric hospitalizations over one year due to AN in two tertiary care hospitals following the onset of the pandemic, confirming the impact that the pandemic has had on children and adolescents with AN in Canada.     

Percentage Body Fat by Dual-Energy X-Ray Absorptiometry Is Associated With Menstrual Recovery in Adolescents With Anorexia Nervosa

PurposeTo evaluate mediators of resumption of menses (ROM) in adolescents with anorexia nervosa (AN).MethodsAnthropometrics, body composition by dual-energy X-ray absorptiometry, hormonal studies, and responses to mental health screens were obtained at 6-month intervals for 18 months in 37 adolescents with AN randomized to the placebo arm of a double-blind treatment trial. Outcomes were compared between subjects with menstrual recovery and those without.ResultsTwenty-four subjects (65%) had ROM. Higher percentage body fat was associated with ROM (odds ratio, 1.19; 95% confidence interval, 1.06, 1.33; p < .01), as was body mass index and percent median body weight. Estradiol ≥30 ng/mL alone did not predict menses (p = .08) but was associated with ROM when coupled with percent mean body weight (odds ratio, 2.49; 95% confidence interval, 1.09, 5.65; p = .03). Changes in leptin, cortisol, and mental health were not associated with return of menses.ConclusionsPercentage body fat may be an additional, useful clinical assessment to follow in caring for adolescents with AN.     

Nutrition Therapy during Initiation of Refeeding in Underweight Children and Adolescent Inpatients with Anorexia Nervosa: A Systematic Review of the Evidence

Restoration of weight and nutritional rehabilitation are recognized as fundamental steps in the therapeutic treatment of children and adolescent inpatients with anorexia nervosa (AN). However, current recommendations on initial energy requirements for this population are inconsistent, with a clear lack of empirical evidence. Thus, the aim of our study was to systematically review, assess, and summarize the available evidence on the effect of differing nutrition therapies prescribed during refeeding on weight restoration in hospitalized children and adolescents (aged 19 years and younger) with diagnosed AN. Searches were conducted in Scopus, Web of Science, Global Health (CABI), PubMed, and the Cochrane database for articles published in English up to May 2012, and complemented by a search of the reference lists of key publications. Seven observational studies investigating a total of 403 inpatients satisfied the inclusion criteria. The range of prescribed energy intakes varied from 1,000 kcal to >1,900 kcal/day with a progressive increase during the course of hospitalization. It appeared that additional tube feeding increased the maximum energy intake and led to greater interim or discharge weight; however, this was also associated with a higher incidence of adverse effects. Overall, the level of available evidence was poor, and therefore consensus on the most effective and safe treatment for weight restoration in inpatient children and adolescents with AN is not currently feasible. Further research on refeeding methods is crucial to establish the best practice approach to treatment of this population.     

南通市3～12岁儿童厌食的分布特征

目的 了解儿童厌食的发生情况以及分布特征,为进一步分析厌食的影响因素和防治厌食提供理论依据。方法 运用随机整群抽样的方法,对南通市2 598名3~12岁儿童进行问卷调查,调查内容包括儿童的一般进食习惯、家庭情况、疾病因素、精神因素、围产期及婴儿期保健等5个方面。结果南通市3~12岁儿童厌食的检出率为14.2％,其中男性15.3％,女性12.9％。不良的进食习惯、父母强制进食、训斥、父母存在挑食等行为方式、消化道疾病、精神状况、围产期及婴儿期保健等因素在厌食儿童中较为多见。结论 饮食习惯、家庭因素、疾病情况、精神状况、围产期及婴儿期保健等因素显著影响厌食儿童的分布。