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目的探讨早期肠道营养对儿童重症手足口病预后的影响。方法将24例重症手足口病患儿随机分成肠道营养观察组12例,对照组12例。入院后24h内对照组给予普通配方奶粉和肉汤喂养,观察组给予高能量配方乳剂喂养,在研究的第1d、7d、14d观察两组患儿血红蛋白、血浆白蛋白、前白蛋白、氮平衡、神经系统Glasgow(GCS)评分、小儿危重症评分指标变化并进行比较。结果对照组14d血红蛋白、白蛋白和前白蛋白较观察组明显下降(P<0.05);观察组7d达到正氮平衡,对照组14d时仍处负氮平衡(P<0.05);观察组GCS评分分值增加,在7d、14d时与对照组比较差异有统计学意义(P<0.05);观察组小儿危重病评分分值增高较快,在7d时与对照组比较差异有统计学意义(P<0.05)。结论早期高能量肠道营养对改善重症手足口病患儿预后有一定作用。
Objective To investigate the effect of early enteral nutrition on the prognosis of severe hand-foot-mouth disease in children. Methods Twenty-four children with severe HFMD were randomly divided into 12 cases of intestinal nutrition observation group and 12 cases of control group. The control group was fed with normal formula and broth within 24 hours after admission. The observation group was fed with high energy formula emulsion. The hemoglobin, plasma albumin, prealbumin, nitrogen balance were observed on the 1st, 7th and 14th day after the study , Neurological Glasgow (GCS) score, pediatric critical illness score changes and compared. Results The levels of hemoglobin, albumin and prealbumin in the control group decreased significantly (P <0.05) on the 14th day. The positive nitrogen balance was observed on the 7th day in the observation group and the negative nitrogen balance on the 14th day in the control group (P <0.05) (P <0.05). At the 7th day and the 14th day, the scores of pediatric critical illness score increased rapidly, and the difference was statistically significant at the 7th day compared with the control group (P <0.05). Conclusion Early high-energy enteral nutrition can improve the prognosis of severe hand-foot-mouth disease in children.