Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
Department of Human Studies, LUMSA University, Rome, Italy.
Dis Esophagus. 2020 Jan 16;33(1). doi: 10.1093/dote/doz102.
Although eating problems have been described as long-term morbidities of esophageal atresia (EA), there have been few studies exploring eating outcomes in children born with EA as primary aim. Parents of children operated on for EA in our Institution from January 2012 to January 2016, answered a telephone structured interview developed specifically to conduct the present study, assessing eating skills at 3 years of age. Clinical data were collected from children's medical records. Parents (45 mothers and 6 fathers) of 51 children (male = 34; female = 17) with a median age of 3.5 years form the object of the study. Considering eating problems, parents reported that 23 children (45%) still have episodes of choking during meals at 3 years of age, 9 (45%) of these have more than one episode a week, and 19 parents (39%) reported higher levels of anxiety during mealtimes. Forty-four children (86%) were described by their parents as able to eat alone, 32 (65%) accepted all food textures and 45 (90%) was described as curious about food (3 years). Forty-three (86%) parents let their children eat with other people. Correlations showed that weaning age was significantly associated with number of dilatations (rs = 0.35, P = 0.012), days of mechanical ventilation (rs = 0.40, P < 0.001), and presence of gastrostomy tube at discharge (rs = 0.45, P < 0.001). Chewing age resulted associated with number of dilatations (rs = 0.34, P < 0.01) and days of mechanical ventilation (rs = 0.38, P < 0.01). Presence of choking episodes was associated with curiosity about food (rs = 0.29, P < 0.05), while frequent choking episodes were associated with higher parental anxiety during mealtimes (rs = 0.45, P < 0.05). In order to prevent delay in the achievement of eating developmental milestones in children operated on of EA, we advocate a dedicated preventive intervention from birth to follow-up.
尽管进食问题已被描述为食管闭锁（EA）的长期病态，但很少有研究以儿童为主要研究对象，探索 EA 患儿的进食结局。2012 年 1 月至 2016 年 1 月期间，我院接受 EA 手术的患儿家长通过电话接受了一项专门设计的结构化访谈，评估了患儿 3 岁时的进食技能。临床数据从患儿病历中收集。研究对象为 51 名患儿的家长（45 名母亲和 6 名父亲），其中男性 34 名，女性 17 名，中位年龄 3.5 岁。考虑到进食问题，父母报告说，3 岁时仍有 23 名儿童（45%）在进食时出现哽噎，其中 9 名（45%）每周哽噎超过一次，19 名家长（39%）报告说在进餐时感到焦虑。44 名儿童（86%）被家长描述为能够独自进食，32 名（65%）接受各种质地的食物，45 名（90%）对食物表现出好奇（3 岁）。43 名（86%）家长让孩子与他人一起进食。相关性分析显示，断奶年龄与扩张次数（rs=0.35，P=0.012）、机械通气天数（rs=0.40，P<0.001）和出院时胃造口管的存在显著相关（rs=0.45，P<0.001）。咀嚼年龄与扩张次数（rs=0.34，P<0.01）和机械通气天数（rs=0.38，P<0.01）相关。出现哽噎与对食物的好奇心相关（rs=0.29，P<0.05），而频繁哽噎与进餐时家长焦虑程度增加相关（rs=0.45，P<0.05）。为了防止 EA 术后患儿进食发育里程碑的延迟，我们提倡从出生开始进行专门的预防干预，直至随访。
