McLaughlin Cory M, Channabasappa Nandini, Pace Jesse, Nguyen Hoa, Piper Hannah G
Department of Surgery, Baylor University Medical Center.
Division of Pediatric Gastroenterology, University of Texas Southwestern/Children's Health.
J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):484-488. doi: 10.1097/MPG.0000000000001762.
Infants with short bowel syndrome (SBS) require diligent nutritional support for adequate growth. Enteral independence is a primary goal, but must be balanced with ensuring sufficient nutrition. We aimed to describe growth trajectory in infants with SBS as function of nutritional intake during first 2 years of life.
Infants with SBS were reviewed (2008-2016). z Scores for weight, height, and head circumference (HC) were recorded at birth, 3, 6, 12, 18, and 24 months. Nutritional intake, serum liver enzyme, and bilirubin levels were assessed at all time points. Pearson correlation coefficients were used to measure association with P < 0.05 considered significant.
Forty-one infants were included, with median gestational age of 34 weeks (interquartile range [IQR] 29-36 weeks). Median small bowel length was 36 cm (IQR 26-52 cm) and median % expected small bowel length was 28% (IQR 20%-42%). Mean z scores for weight and length were >0 at birth, but <0 from 3 months to 2 years. HC remained <0 throughout the study. Mean z scores at 2 years for weight, length, HC, and weight-for-length were -0.90 (SD 1.1), -1.33 (SD 1.4), -0.67 (SD 1.2), and -0.12 (SD 1.2), respectively. Percentage calories from PN was positively correlated with weight in the first 3 months of life (P = 0.01).
Babies with SBS are high risk for poor growth during the first 2 years of life. Although weaning PN is important for these patients, doing so too quickly in infancy may contribute to compromised growth. The long-term impact on overall development is not known.
短肠综合征（SBS）婴儿需要精心的营养支持以实现充分生长。肠道自主喂养是主要目标，但必须与确保充足营养相平衡。我们旨在描述SBS婴儿在生命最初2年中营养摄入与生长轨迹之间的关系。
对2008年至2016年期间的SBS婴儿进行回顾性研究。记录出生时、3个月、6个月、12个月、18个月和24个月时的体重、身高和头围（HC）的z评分。在所有时间点评估营养摄入、血清肝酶和胆红素水平。采用Pearson相关系数来衡量相关性，P<0.05被认为具有统计学意义。
纳入41例婴儿，中位胎龄为34周（四分位间距[IQR]29 - 36周）。中位小肠长度为36 cm（IQR 26 - 52 cm），预期小肠长度的中位百分比为28%（IQR 20% - 42%）。出生时体重和身长的平均z评分>0，但从3个月到2岁时<0。在整个研究期间，HC始终<0。2岁时体重、身长、HC和身长别体重的平均z评分分别为-0.90（标准差1.1）、-1.33（标准差1.4）、-0.67（标准差1.2）和-0.12（标准差1.2）。出生后前3个月肠外营养提供的卡路里百分比与体重呈正相关（P = 0.01）。
SBS婴儿在生命的前2年生长发育不良的风险很高。虽然断奶期停用肠外营养对这些患者很重要，但在婴儿期过快停用可能会导致生长发育受损。对整体发育的长期影响尚不清楚。
