Pahsini Karoline, Marinschek Sabine, Khan Zahra, Dunitz-Scheer Marguerite, Scheer Peter Jaron
Department for General Pediatrics and Psychosomatic, Medical University of Graz, Graz, Austria.
J Pediatr Gastroenterol Nutr. 2016 Jan;62(1):169-73. doi: 10.1097/MPG.0000000000000919.
The present study highlights the occurrence of unintended adverse effects of enteral nutrition in infancy and childhood, as viewed and reported from a parental perspective.
Quantitative analysis of a standardized questionnaire, filled out online by parents of enterally fed children. The questions focused on the nutritive and nonnutritive adverse effects, and other medical and biometric data. Data were collected from January 1, 2009 to December 31, 2013.
The study cohort consisted of 425 infants and children with different underlying medical conditions and an average age of 2.17 (median = 1.63) years. Nasogastric tubes were used in 44.2% of all the patients, and 55.8% of the children were fed by percutaneous endoscopic gastrostomy tube. Nearly all of the children have been tube-fed since birth. A total of 56.0% of all tube-fed children showed regular gagging and retching episodes, 50.0% vomited frequently, 14.8% experienced nausea, 7.5% experienced extreme nervous perspiration during the feeding, 45.2% showed loss of appetite, 5.2% experienced local granulation tissue, and 1.9% had other skin irritations. No significant correlations could be found between age, sex, medical diagnoses, type of feeding tube, feeding schedules (bolus or continuous), and parental and child's behavior regarding the feeding situation and duration of tube feeding.
Enteral nutrition affects the child and the whole family system on more than just nutritional level. It is suggested that children and their families should be followed-up by health professionals periodically for nutritional optimization, growth documentation, and other aspects of tube management.
本研究从家长的视角,着重探讨婴幼儿期肠内营养意外不良影响的发生情况及报告。
对经肠内喂养儿童的家长在线填写的标准化问卷进行定量分析。问题聚焦于营养性和非营养性不良影响以及其他医学和生物特征数据。数据收集时间为2009年1月1日至2013年12月31日。
研究队列包括425名患有不同基础疾病的婴幼儿,平均年龄为2.17岁(中位数 = 1.63岁)。所有患者中44.2%使用鼻胃管,55.8%的儿童通过经皮内镜下胃造口管喂养。几乎所有儿童自出生起就接受管饲。在所有接受管饲的儿童中,共有56.0%出现规律性的作呕和干呕发作,50.0%频繁呕吐,14.8%感到恶心,7.5%在喂养期间出现极度紧张性出汗,45.2%食欲不振,5.2%出现局部肉芽组织,1.9%有其他皮肤刺激症状。在年龄、性别、医学诊断、喂养管类型、喂养方案(推注或持续喂养)以及家长和儿童在喂养情况及管饲持续时间方面的行为之间,未发现显著相关性。
肠内营养对儿童及其整个家庭系统的影响不止于营养层面。建议健康专业人员定期对儿童及其家庭进行随访,以优化营养状况、记录生长情况并进行管饲管理的其他方面。