胆道闭锁Kasai术后自肝生存患儿体格发育Z评分

目的 本研究旨在对胆道闭锁Kasai术后自肝生存患儿的体格发育进行评价,了解胆道闭锁Kasai术后自肝生存患儿营养状况.方法 本研究采用横断面调查方式,于2014年10月至2015年1月对首都医科大学附属北京儿童医院普外科胆道闭锁Kasai术后自肝生存定期门诊复查的96例患儿进行体格测量(身高/身长、体重).采用WHO Anthro Plus 2007软件,计算年龄别身高/身长Z评分(Height for Age Z-score,HAZ)、年龄别体重Z评分(Weight for Age Z-score,WAZ)、身高别体重Z评分(Weight for Height Z-score,WHZ).统计我中心Ksasi术后自肝生存患儿生长迟缓、低体重、消瘦的患病率.采用方差分析或t检验,描述不同分组Z评分结果差异.结果 ①纳入研究的96例Kasai术后自肝生存患儿HAZ、WAZ、WHZ均值分别为-0.38±0.17、0.33±0.17、0.88±0.17;②生长迟缓(HAZ＜-2)患病率为14.58％(14/96),低体重(WAZ＜-2)患病率为5.21％(5/96),消瘦(WHZ＜-2)患病率为3.13％(3/96);③以年龄(月)分组,6～12个月组患儿HAZ、WAZ、WHZ均值均为负值,分别为-0.27±0.12、-0.55±0.37、-0.30±0.25;④以术时年龄(d)分组,＜60 d、60～90 d组患儿的WHZ均值均为正值,分别为1.08±0.27、0.85±0.25,＞90 d组患儿WHZ均值为负值,-0.26±0.24.结论①胆道闭锁Kasai术后自肝生存患儿存在营养不良问题,其中生长迟缓问题更为突出;②6～12个月组患儿HAZ、WAZ、WHZ均值均低于国际标准值(0),并且6～12个月组患儿WAZ、WHZ明显低于13～24个月组和≥25个月组,因此Kasai术后自肝生存患儿婴儿期营养状况尤其值得关注;③术时年龄＞90d组患儿WHZ明显低于＜60d组和60～90d组,所以尽早手术对于提升患儿术后营养状况有帮助.

Application of Z score in evaluating the growth of biliary atresia patients after Kasai procedure

Objective To evaluate the physical growth of biliary atresia (BA) patients after Kasai procedure by using Z score and compare the data among different groups.Methods Using a cross section method,96 children with postoperative BA were evaluated for height/length and weight.WHO AnthroPlus 2007 was used for calculating Z score.Analysis of variance or t test were used for comparing Z scores among different groups.Results The prevalence of stunting (height for age Z-score,HAZ＜-2),underweight (weight for age Z-score,WAZ＜-2) and wasting (weight for height Z-score,WHZ＜-2) were 14.58％(14/96),5.21％(5/96) and 3.13％(3/96);overall mean Z scores of HAZ,WAZ,WHZ-0.38 ± 0.17,0.33 ± 0.17 and 0.88 ± 0.17;mean Z scores of HAZ,WAZ,WHZ of ＜12 months group-0.27 ± 0.12,-0.55 ± 0.37 and-0.30 ± 0.25 respectively.According to age,WHZ of ＜60 days,60～90 days and ＞90 days were 1.08 ± 0.27,0.85 ± 0.25 and-0.26 ±0.24 respectively.Conclusions After Kasai operation,BA patients suffer from malnutrition.And the problem of stunting is more serious.Poor nutritional status is more frequent for those aged ＜ 12months.Thus nutritional status of infants is particularly worrisome.As for operative age,＞90 days group has more serious nutritional problems so that early Kasai operation helps improve nutritional status.