Maffei H V, Padula N N, Annicchino G P, Ferrari G F, Goldberg T B
Department of Pediatrics, Faculdade de Medicina de Botucatu, UNESP, Brazil.
J Trop Pediatr. 1990 Oct;36(5):240-6. doi: 10.1093/tropej/36.5.240.
The nutritional management of infants admitted with diarrhoea to the University Hospital of Botucatu includes a change from bolus feeding of a modulated minced-chicken formula to a continuous nasogastric drip (NGD) feeding, whenever the required calorie intake is not achieved or the diarrhoea does not subside. To evaluate this approach, the clinical course and weight changes of 63 children, aged 1-20 months, were reviewed; most (81 per cent) were below the third percentile for weight at admission and 76 per cent had a total duration of diarrhoea greater than or equal to 10 days. Associated infections, mainly systemic, were present at or after admission in 70 per cent of them. Twenty-five survivors needed nutritional support (NS), predominantly NGD, for a median duration of 30 per cent of their admission time, and were compared to 31 survivors managed without NS. Those who necessitated NS lost weight for a significantly longer median time (12 x 4 days, p less than 0.005), but their total weight loss was similar (5 x 4 per cent) as well as diarrhoea's duration (8 x 7 days). There was a tendency for a longer hospitalization (21 x 16 days 0.05 less than P less than 0.10) and a longer span to begin weight gain after diarrhoea's end for the group with NS (p less than 0.05), but subsequent growth quotient and daily weight gain during admission were similar for both groups. Both groups of survivors received similar amounts of energy, although the initial increase was delayed for those who needed the NGD.(ABSTRACT TRUNCATED AT 250 WORDS)
对入住博图卡图大学医院的腹泻婴儿进行营养管理时,只要所需热量摄入未达到或腹泻未消退,就会从采用调制碎鸡肉配方奶的推注喂养改为持续鼻胃管滴注(NGD)喂养。为评估这种方法,回顾了63名1至20个月大儿童的临床病程和体重变化;大多数(81%)入院时体重低于第3百分位数,76%的儿童腹泻总时长大于或等于10天。70%的患儿在入院时或入院后伴有主要为全身性的感染。25名存活者需要营养支持(NS),主要是NGD,营养支持的中位时长占其住院时间的30%,并将他们与31名未接受NS治疗的存活者进行比较。那些需要NS的患儿体重下降的中位时间明显更长(12×4天,p<0.005),但他们的总体体重减轻相似(5×4%),腹泻时长也相似(8×7天)。NS组有住院时间更长的趋势(21×16天,0.05<P<0.10),腹泻结束后开始体重增加的时间跨度也更长(p<0.05),但两组患儿入院期间的后续生长商和每日体重增加相似。两组存活者获得的能量总量相似,尽管需要NGD的患儿能量最初增加有所延迟。(摘要截选至250词)