在治疗性养计划中,五岁以下严重营养不良儿童的体重增加:系统性审查和元分析
Grace O'Donovan1, Daniel Allen1, Thandile Nkosi-Gondwe1,2
1Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
EClinicalMedicine
|March 3, 2025
概括
儿童严重营养不良在门诊计划中体重增加较慢,与住院护理相比. 这一系统性审查为未来的治疗准则和政策提供了基准.
科学领域:
- 公共卫生 公共卫生
- 儿科 儿科 儿科
- 营养科学 营养科学
背景情况:
- 在全球范围内,有4500万5岁以下的儿童经历消耗 (体重低而身高低).
- 目前世界卫生组织的指导方针建议,的儿童每天体重增加5-10克/公斤,这与之前的10-15克/公斤/天目标有所不同.
- 了解最佳体重增长目标对于政策和规划的信息至关重要.
研究的目的:
- 系统地审查和元分析严重营养不良儿童体重增加率的数据.
- 为了比较不同治疗方式的体重增加:住院,门诊和混合.
- 根据严重营养不良的体重增加目标,为未来的政策和规划提供信息.
主要方法:
- 通过Embase,全球健康和Medline数据库识别的研究的系统审查和元分析.
- 纳入标准:6-59个月的严重营养不良儿童接受住院,门诊或混合治疗.
- 主要结果:平均体重增加率 (g/kg/day);用于探索与停留时间和结果的关联的元回归.
主要成果:
- 对104篇论文 (240,650名参与者) 的分析显示,平均体重增加率为8.8g/kg/天 (住院患者),3.4g/kg/天 (混合患者),3.9g/kg/天 (门诊患者).
- 门诊计划中的体重增加明显比住院治疗慢.
- 发现了较慢的体重增加和较高的死亡率之间存在关联的不一致的证据,在调整为计划类型后证据较弱.
结论:
- 在治疗严重营养不良的住院和门诊治疗之间,体重增加率显著不同.
- 需要对体重增加计算进行标准化报告,并进一步研究恢复率的后续情况.
- 这些发现为评估当前严重营养不良治疗计划奠定了关键的基准.
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