Green Corkins Kelly, Teague Erin E
Nutrition Therapy Department, LeBonheur Children's Hospital, Memphis, Tennessee, USA.
Akron Children's Hospital, Akron, Ohio, USA.
Nutr Clin Pract. 2017 Feb;32(1):40-51. doi: 10.1177/0884533616679639.
Pediatric patients with chronic illnesses or diseases or who require long-term nutrition support are most vulnerable to nutrition-related issues. Malnutrition in a pediatric patient may negatively affect long-term growth and development. Children also become malnourished much more quickly than adults. A comprehensive nutrition assessment that includes food and nutrition-related history, anthropometric measurements, biochemical data, medical tests and procedures, nutrition-focused physical findings, and patient history should be completed on these patients as no one parameter is a comprehensive indicator of nutrition status. Anthropometric measurements provide important information on the growth and nutrition status of a child, yet many times it is difficult to get accurate and valid measurements due to physical limitations of the child or improper technique. Inaccurate measurements may result in a missed diagnosis of malnutrition or may lead to an incorrect diagnosis of a healthy child. Knowledge of appropriate anthropometric measurements and alternatives is crucial when assessing growth in all children and essential for those who are physically handicapped or critically ill. The purpose of this review is to present key components of a pediatric nutrition assessment so proper nutrition-related diagnosis, including malnutrition, can be accomplished, a nutrition care plan established, and expected outcomes documented.
患有慢性疾病或需要长期营养支持的儿科患者最易出现与营养相关的问题。儿科患者的营养不良可能会对其长期生长发育产生负面影响。儿童比成人更容易出现营养不良。应对这些患者进行全面的营养评估，评估内容包括与食物和营养相关的病史、人体测量、生化数据、医学检查和程序、以营养为重点的体格检查结果以及患者病史，因为没有一个参数能全面反映营养状况。人体测量可提供有关儿童生长和营养状况的重要信息，但由于儿童身体限制或测量技术不当，很多时候难以获得准确有效的测量结果。测量不准确可能导致漏诊营养不良，或对健康儿童做出错误诊断。在评估所有儿童的生长情况时，了解适当的人体测量方法及替代方法至关重要，对于身体有残疾或危重症儿童更是必不可少。本综述的目的是介绍儿科营养评估的关键组成部分，以便能够做出包括营养不良在内的与营养相关的正确诊断，制定营养护理计划，并记录预期结果。
