Ishizaki Akiko, Hironaka Shouji, Tatsuno Masaru, Mukai Yoshiharu
Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan.
Pediatr Int. 2013 Apr;55(2):208-13. doi: 10.1111/ped.12030.
Despite resolution of the symptoms of eating and/or swallowing disorders, prolonged tube feeding is maintained in some children. This study summarized the characteristics of children with tube dependence and investigated the causes of tube dependence.
Clinical and growth data were evaluated using medical records and referral forms for 35 tube-dependent children.
The children in this study had a median age of 30 months (range, 17-37 months) on the first visit and 35.5 months (range, 21.3-44.8 months) at tube removal. Seven children were not weaned from the feeding tube within the study period. Twenty-two (63%) of the children were girls, 20 (57%) were able to walk, 24 (69%) had mild mental retardation, and 33 (94%) had underlying disease. Tube-dependent children tended to weigh less than age-matched normal children. Sixteen children (45.7%) were underweight. Children who had their feeding tubes removed before age 3 were significantly younger at the initial visit than those who had their tubes removed after 3 years of age. Increased finger feeding was observed during the period before tube removal.
Tube-dependent children tend to be close to normal in body growth and intellectual development. When weaning from tube feeding, interventions at earlier ages are more efficient. Reduction in or discontinuation of tube feeding and encouragement of self-feeding were effective to wean off tube feeding.
尽管进食和/或吞咽障碍的症状已得到缓解,但一些儿童仍长期接受管饲喂养。本研究总结了管饲依赖儿童的特征,并调查了管饲依赖的原因。
使用35例管饲依赖儿童的病历和转诊表评估临床和生长数据。
本研究中的儿童首次就诊时的中位年龄为30个月(范围17 - 37个月),拔除饲管时为35.5个月(范围21.3 - 44.8个月)。7名儿童在研究期间未成功从饲管喂养中断奶。22名(63%)儿童为女孩,20名(57%)能够行走,24名(69%)有轻度智力障碍,33名(94%)有基础疾病。管饲依赖儿童的体重往往低于年龄匹配的正常儿童。16名儿童(45.7%)体重不足。在3岁前拔除饲管的儿童首次就诊时的年龄显著低于3岁后拔除饲管的儿童。在拔除饲管前的一段时间内观察到手指喂食增加。
管饲依赖儿童在身体生长和智力发育方面往往接近正常。在从管饲喂养断奶时,早期干预更有效。减少或停止管饲喂养并鼓励自主进食对断奶有效。