胆道闭锁Kasai术后自肝生存患儿体格发育Z评分 |
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引用本文: | 王丽,陈亚军,张廷冲,冯欣,彭春辉,庞文博,王增萌,沈秋龙.胆道闭锁Kasai术后自肝生存患儿体格发育Z评分[J].中华小儿外科杂志,2016(5):331-335. |
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作者姓名: | 王丽 陈亚军 张廷冲 冯欣 彭春辉 庞文博 王增萌 沈秋龙 |
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作者单位: | 首都医科大学附属北京儿童医院外科,北京,100045 |
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基金项目: | 国家自然科学基金(81541100),天津市卫生计生委攻关项目(14KG129),北京市医院管理局临床医学发展专项经费资助(编号:XMLX201603)National Natural Science Foundation of China(81541100),Tianjin Health Bureau Key Project(14KG129),Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support(XMLX201603) |
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摘 要: | 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.
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关 键 词: | 胆道闭锁 体格检查 Z评分 |
Application of Z score in evaluating the growth of biliary atresia patients after Kasai procedure |
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Abstract: | 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. |
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Keywords: | Biliary atresia Physical examination Z-score |
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