论文部分内容阅读
目的 :运用STRONGkids评价分析外科恶性肿瘤患儿的营养风险并研究早期营养干预对预后的影响。方法 :采用儿童营养风险筛查工具STRONGkids(screening tool risk on nutritional status and growth)对2013年3月—2014年12月南京市儿童医院普外科收治的112例恶性肿瘤患儿进行营养风险筛查与管理。以STRONGkids评分≥4分为高度营养风险,将存在高度营养风险的患儿601例随机分为干预组和非干预组,干预方法为早期实施肠内营养,分别测定比较两组患儿入院时、术后10 d的体重、血清白蛋白(ALB)、免疫球蛋白Ig A、视黄醇结合蛋白(RBP),并于术后3个月门诊随访记录患儿体重变化,同时对术后并发症进行分析评估。结果:共筛查出60例存在高度营养风险的恶性肿瘤患儿,将其随机分为干预组(A组30例)和非干预组(B组30例),A组患儿术后10 d的体重、血清白蛋白、免疫球蛋白Ig A、视黄醇结合蛋白较B组明显改善,差异有统计学意义(P<0.05),术后3个月A组患儿体重较B组明显增加,差异有统计学意义(P<0.05),A组患儿术后并发症发生率明显低于B组。结论:STRONGkids能有效评估恶性肿瘤患儿的营养风险,早期进行营养评估、干预和管理可以改善患儿的营养状况,降低术后并发症的发生率。
OBJECTIVE: To evaluate the nutritional risk of children with surgical malignancy using STRONGkids evaluation and to study the effect of early nutritional intervention on prognosis. Methods: A total of 112 malignant tumor patients admitted to Department of General Surgery, Nanjing Children’s Hospital from March 2013 to December 2014 were screened for nutrition risk using the STRONGkids (screening tool risk on nutritional status and growth) management. To STRONGkids score ≥ 4 is divided into high nutritional risk, there will be a high risk of nutrition in children with 601 cases were randomly divided into intervention group and non-intervention group, the intervention method for the early implementation of enteral nutrition, were measured when the two groups of children admitted to hospital, Body weight, serum albumin (ALB), IgA and RBP were measured at 10 days after operation. The changes of body weight in children were followed up at 3 months after operation. The postoperative complications For analysis and evaluation. Results: A total of 60 children with malignant tumor at high nutritional risk were screened and randomly divided into intervention group (30 cases) and non-intervention group (30 cases), group A Body weight, serum albumin, immunoglobulin Ig A, retinol binding protein significantly improved compared with B group, the difference was statistically significant (P <0.05), three months after the group A children with body weight was significantly increased compared with the B group , The difference was statistically significant (P <0.05), A group of children with postoperative complications was significantly lower than the B group. Conclusion: STRONGkids can effectively assess the nutritional risk of children with malignant tumors. Early nutritional assessment, intervention and management can improve the nutritional status of children and reduce the incidence of postoperative complications.