Holenweg-Gross C, Newman C J, Faouzi M, Poirot-Hodgkinson I, Bérard C, Roulet-Perez E
Paediatric Neurology and Rehabilitation Unit, University Hospital, Lausanne, Switzerland.
Child Care Health Dev. 2014 Jul;40(4):525-32. doi: 10.1111/cch.12085. Epub 2013 Aug 1.
To estimate the prevalence of undernutrition among children with profound intellectual and multiple disabilities (PIMD) and to explore its influence on quality of life.
Seventy-two children with PIMD (47 male; 25 female; age range 2 to 15 years 4 months; mean age 8.6, SD 3.6) underwent an anthropometric assessment, including body weight, triceps skinfold thickness, segmental measures and recumbent length. Undernutrition was determined using tricipital skinfold percentile and z-scores of weight-for-height and height-for-age. The quality of life of each child was evaluated using the QUALIN questionnaire adapted for profoundly disabled children.
Twenty-five children (34.7%) were undernourished and seven (9.7%) were obese. Among undernourished children only eight (32 %) were receiving food supplements and two (8%) had a gastrostomy, of which one was still on a refeeding programme. On multivariate analysis, undernutrition was one of the independent predictors of lower quality of life.
Undernutrition remains a matter of concern in children with PIMD. There is a need to better train professionals in systematically assessing the nutritional status of profoundly disabled children in order to start nutritional management when necessary.
评估重度智力和多重残疾（PIMD）儿童的营养不良患病率，并探讨其对生活质量的影响。
72名PIMD儿童（47名男性；25名女性；年龄范围2至15岁4个月；平均年龄8.6岁，标准差3.6）接受了人体测量评估，包括体重、肱三头肌皮褶厚度、分段测量和卧位长度。使用肱三头肌皮褶百分位数以及身高别体重和年龄别身高的z评分来确定营养不良情况。使用适用于重度残疾儿童的QUALIN问卷评估每个儿童的生活质量。
25名儿童（34.7%）营养不良，7名（9.7%）肥胖。在营养不良的儿童中，只有8名（32%）接受食物补充剂，2名（8%）有胃造口术，其中1名仍在进行重新喂养计划。多因素分析显示，营养不良是生活质量较低的独立预测因素之一。
营养不良仍是PIMD儿童需要关注的问题。有必要对专业人员进行更好的培训，以便系统地评估重度残疾儿童的营养状况，从而在必要时启动营养管理。
