对脑瘫患儿进行胃造口管饲会增加呼吸疾病的发病风险吗？
Does gastrostomy tube feeding in children with cerebral palsy increase the risk of respiratory morbidity?
作者信息
Sullivan P B, Morrice J S, Vernon-Roberts A, Grant H, Eltumi M, Thomas A G
机构信息
Department of Paediatrics, University of Oxford, Oxford, UK.
出版信息
Arch Dis Child. 2006 Jun;91(6):478-82. doi: 10.1136/adc.2005.084442. Epub 2006 Jan 30.
BACKGROUND
Children with severe neurological impairment may have significant oral motor dysfunction and are at increased risk of nutritional deficiencies, poor growth, and aspiration pneumonia. Gastrostomy tube feeding is increasingly being used for nutritional support in these children.
AIM
To examine the occurrence of respiratory morbidity before and after gastrostomy feeding tube insertion in children with severe neurological disabilities.
METHODS
This study was nested in a longitudinal, prospective, uncontrolled, multicentre cohort study designed to investigate the outcomes of gastrostomy tube feeding in 57 children with severe neurological disabilities. Parents completed a questionnaire prior to (visit 1) and 6 and 12 months (visits 2 and 3) following the gastrostomy, detailing number of chest infections requiring antibiotics and/or hospital admission.
RESULTS
Mean number of chest infections requiring antibiotics was 1.8 on visit 1 and 0.9 on visit 3. Hospital admissions for chest infections fell significantly from 0.5 to 0.09.
CONCLUSION
This study provides no evidence for an increase in respiratory morbidity following insertion of a feeding gastrostomy in children with cerebral palsy.
背景
患有严重神经功能障碍的儿童可能存在明显的口腔运动功能障碍，并且营养缺乏、生长发育不良和吸入性肺炎的风险增加。胃造口管喂养越来越多地用于这些儿童的营养支持。
目的
研究严重神经功能残疾儿童插入胃造口喂养管前后呼吸系统疾病的发生情况。
方法
本研究嵌套于一项纵向、前瞻性、非对照、多中心队列研究中，该研究旨在调查57例严重神经功能残疾儿童胃造口管喂养的结果。家长在胃造口术前（访视1）以及术后6个月和12个月（访视2和3）完成一份问卷，详细说明需要使用抗生素和/或住院治疗的胸部感染次数。
结果
访视1时需要使用抗生素的胸部感染平均次数为1.8次，访视3时为0.9次。因胸部感染住院的次数从0.5次显著降至0.09次。
结论
本研究没有提供证据表明脑瘫儿童插入喂养胃造口管后呼吸系统疾病会增加。
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