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短肠综合征儿童的亲肠支持和微量营养素缺乏:一项全面的回顾性研究
V Chatzidaki1, R Wood1, A Alegakis2
1Department of Pediatric Gastroenterology, Royal Manchester Children's Hospital, NHS Foundation Trust, UK.
Clinical nutrition ESPEN
|December 6, 2023
概括
患有短肠综合征 (SBS) 的儿童需要长时间的肠道支 (PS),通常具有先天性原因,即使在实现肠道自主 (EA) 后,他们也面临微量营养素缺乏的风险. 肠道长度是EA的一个关键预测指标.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 肠道康复 肠道康复
- 营养支持 营养支持
背景情况:
- 短肠综合征 (SBS) 是儿童慢性肠衰竭的主要原因.
- 在儿科SBS中,亲肠支 (PS) 持续时间和微量营养素需求有很大差异.
- 确定长期PS和长期微量营养素补充的高风险群体至关重要.
研究的目的:
- 审查患有SBS和慢性肠衰竭的儿童的临床过程.
- 确定患有长期PS风险较高的患者子组.
- 为了确定长期微量营养素补充需求的风险.
主要方法:
- 对SBS儿童的电子医疗记录的回顾性审查,需要PN>60天.
- 纳入标准: >3年随访和PN依赖.
- 使用IBM SPSS统计的统计分析 24.0.0.
主要成果:
- 40/54名儿童实现了肠道自主 (EA);14名儿童在36个月后仍然在PS上.
- 更长的肠道长度预测了EA (27.5%对6.0%,p<0.001).
- 先天性诊断 (例如,死角性肠球炎,胃) 与较长的PN依赖 (21.0与8.7个月,p=0.02) 有关.
- 达到EA的儿童中有87.5%的微量营养素缺乏 (维生素D,铁,B12,E).
- 缺铁和维生素A缺乏与更长的PS持续时间相关.
结论:
- 小肠长度是儿童SBS中实现肠道自主性的主要预测因素.
- 需要长期PS的儿童,特别是具有先天性原因的儿童,在过渡到EA后面临更高的微量营养素缺乏的风险.
- 对于患有SBS的儿童来说,早期识别和管理微量营养素需求至关重要.
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