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CHARGE综合征患儿的喂养经历及胃肠功能障碍

Experiences in feeding and gastrointestinal dysfunction in children with CHARGE syndrome.

作者信息

Macdonald Meghan, Hudson Alexandra, Bladon Angela, Ratcliffe Elyanne, Blake Kim

机构信息

Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada.

McMaster Children's Hospital, Hamilton, Ontario, Canada.

出版信息

Am J Med Genet A. 2017 Nov;173(11):2947-2953. doi: 10.1002/ajmg.a.38458. Epub 2017 Sep 22.

Abstract

Feeding issues are very common in individuals with CHARGE syndrome and can lead to increased morbidity and mortality. The aim of this study was to expand upon the limited knowledge base of feeding and gastrointestinal issues in individuals with CHARGE syndrome. Parents of individuals (age range 1-18 years) with CHARGE syndrome, with or without feeding/gastrointestinal issues, were recruited through international CHARGE syndrome associations and CHARGE syndrome Facebook pages. Parents completed three questionnaires: CHARGE diagnostic characteristics; Pediatric Assessment Scale for Severe Feeding Problems © and PedsQL™ Gastrointestinal Symptoms Scale; and open-ended questions. Sixty-nine completed questionnaires were included in the study analysis (median age 7; 58% females). Individuals who were completely tube fed (n = 21) had significantly more feeding difficulties than individuals who were either partially (n = 26) or completely orally fed (n = 20; p < 0.001). Tube fed individuals also experienced more problematic gastrointestinal symptoms (p < 0.001). Constipation (n = 19, 30%), vomiting (n = 12, 19%), and choking (n = 11, 17%) were reported by parents as the greatest challenges. Problems exist throughout the entire gastrointestinal tract in many individuals with CHARGE syndrome. These issues are more common in individuals who receive nutrition completely through a feeding tube compared to individuals with at least partial oral feeding behaviors.

摘要

喂养问题在患有CHARGE综合征的个体中非常常见,并且可能导致发病率和死亡率增加。本研究的目的是扩充关于CHARGE综合征个体喂养和胃肠道问题的有限知识基础。通过国际CHARGE综合征协会和CHARGE综合征脸书页面招募了年龄在1至18岁之间、有或没有喂养/胃肠道问题的CHARGE综合征个体的父母。父母完成了三份问卷:CHARGE诊断特征;严重喂养问题儿科评估量表©和儿童生活质量量表™胃肠道症状量表;以及开放式问题。69份完成的问卷被纳入研究分析(中位年龄7岁;58%为女性)。完全通过管饲喂养的个体(n = 21)比部分(n = 26)或完全经口喂养的个体(n = 20;p < 0.001)有明显更多的喂养困难。管饲喂养的个体也有更多的胃肠道问题(p < 0.001)。父母报告便秘(n = 19,30%)、呕吐(n = 12,19%)和呛噎(n = 11,17%)是最大的挑战。许多CHARGE综合征个体的整个胃肠道都存在问题。与至少有部分经口喂养行为的个体相比,这些问题在完全通过喂养管接受营养的个体中更为常见。

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