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脑瘫与管饲喂养的生活:一项基于人群的随访研究。

Living with cerebral palsy and tube feeding: A population-based follow-up study.

作者信息

Smith S W, Camfield C, Camfield P

机构信息

Dalhousie University Medical School and IWK-Grace Health Centre, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

J Pediatr. 1999 Sep;135(3):307-10. doi: 10.1016/s0022-3476(99)70125-3.

Abstract

OBJECTIVES

To assess the impact of surgically placed feeding tubes on children with severe cerebral palsy (CP) and their families and to determine the survival of these children after initiation of tube feeding (TF).

METHODS

Virtually all children from Nova Scotia who had gastrostomy or jejunostomy procedures between the years 1980 and 1998 and who had been diagnosed with CP were identified. Caretakers of those children who had TF initiated in the last 8 years were evaluated by using a semi-structured interview. Names of children who had not had recent follow-up visits were submitted to the provincial Vital Statistics office to determine whether they had died. Data from patients who were tube-fed between 1980 and 1989 were then used in combination with data from the more recent cases to create a survival curve.

RESULTS

A total of 61 children were identified; 16 had died. Forty of 45 eligible families were interviewed; 90% were pleased with the effect of TF on their child and family life. Negative reports were associated with increased stress related to feeding. Survival rates after gastrostomy and/or jejunostomy were 83% after 2 years and 75% after 7 years.

CONCLUSIONS

In children with severe CF, initiation of TF improved the quality of life for both the child and family in 90% despite frequent minor complications.

摘要

目的

评估手术置入喂养管对重度脑瘫(CP)患儿及其家庭的影响,并确定开始管饲喂养(TF)后这些患儿的生存率。

方法

确定了1980年至1998年间在新斯科舍省接受胃造口术或空肠造口术且被诊断为CP的几乎所有患儿。对过去8年开始接受TF的患儿的照料者进行了半结构化访谈评估。将近期未进行随访的患儿姓名提交给省级生命统计办公室,以确定他们是否已经死亡。然后将1980年至1989年间接受管饲喂养的患者数据与近期病例的数据结合起来,绘制生存曲线。

结果

共确定了61名患儿;其中16名已经死亡。对45名符合条件的家庭中的40名进行了访谈;90%的家庭对TF对其孩子和家庭生活的影响感到满意。负面报告与喂养相关的压力增加有关。胃造口术和/或空肠造口术后2年的生存率为83%,7年的生存率为75%。

结论

在重度CF患儿中,尽管经常出现轻微并发症,但开始TF后90%的患儿及其家庭的生活质量得到了改善。

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