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痉挛性四肢瘫脑瘫患者营养状况评估及与喂养相关并发症的发生频率。

ASSESSMENT OF NUTRITIONAL STATUS AND FREQUENCY OF COMPLICATIONS ASSOCIATED TO FEEDING IN PATIENTS WITH SPASTIC QUADRIPLEGIC CEREBRAL PALSY.

机构信息

Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.

Centro Universitário do Triângulo, Uberlândia, MG, Brazil.

出版信息

Rev Paul Pediatr. 2020;38:e2018410. doi: 10.1590/1984-0462/2020/38/2018410. Epub 2020 May 11.

Abstract

OBJECTIVE

To correlate the nutritional status with variables associated to the type of diet and feeding route of children and adolescents with spastic quadriplegic cerebral palsy (CP).

METHODS

This cross-sectional study included 28 patients aged ≤13 years old who presented a diagnosis of spastic quadriplegic CP and were followed by the nutrition team of the Outpatient Clinic for Special Patients of Hospital de Clínicas de Uberlândia - Universidade Federal de Uberlândia (HC-UFU), between July/2016 and January/2017. Consent forms were signed by the legal guardians. The nutritional status was evaluated and data on dietary complications food route and type of diet were collected. For the description of data, average and median values were used. Correlation was tested with Spearman's index. Significance was set at p<0.05.

RESULTS

75% of patients used alternative feeding routes (nasoenteral, catheter or gastrostomy), 57% were eutrophic. The most frequent complications were oropharyngeal dysphagia, reflux and intestinal constipation. No correlation was found between the occurrence of complications and the nutritional status. There was a positive correlation between the diet received and the patient's nutritional status (0.48; p=0.01), i.e. individuals with adequate caloric and macronutrients intake had a better nutritional status.

CONCLUSIONS

The results reinforce the need for continued nutritional guidance for the children's parents/caregivers, as well as the choice of an adequate rout of feeding to each child by the multi-professional team, in order to contribute to improved nutritional status and adequate dietary intake.

摘要

目的

分析痉挛型四肢瘫脑瘫患儿的营养状况与饮食类型和喂养途径相关变量的相关性。

方法

本横断面研究纳入了 2016 年 7 月至 2017 年 1 月在 Hospital de Clínicas de Uberlândia - Universidade Federal de Uberlândia(HC-UFU)特需门诊营养团队随访的 28 名≤13 岁痉挛型四肢瘫脑瘫患儿。签署了法定监护人同意书。评估了营养状况,并收集了饮食并发症、食物途径和饮食类型的数据。数据描述采用平均值和中位数。采用 Spearman 指数进行相关性检验,显著性水平为 p<0.05。

结果

75%的患儿采用了替代喂养途径(鼻肠管、导管或胃造口),57%为营养良好。最常见的并发症是口咽吞咽困难、反流和肠道便秘。并发症的发生与营养状况之间无相关性。所接受的饮食与患者的营养状况呈正相关(0.48;p=0.01),即摄入足够热量和宏量营养素的个体具有更好的营养状况。

结论

这些结果强调了需要持续为患儿的家长/照顾者提供营养指导,以及多专业团队为每个患儿选择合适的喂养途径,以改善营养状况和饮食摄入。

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