Solanki Shailesh, Bhatnagar Veereshwar, Agarwala Sandeep, Lodha Rakesh, Gupta Nandita, Singh Manoj Kumar
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Pediatric Medicine, All India Institute of Medical Sciences, New Delhi, India.
J Indian Assoc Pediatr Surg. 2020 May-Jun;25(3):147-150. doi: 10.4103/jiaps.JIAPS_17_19. Epub 2020 Apr 11.
Nutritional depletion and growth stunting are present in patients with biliary atresia; "normal" nutrient and vitamin supplementation fail to correct these deficiencies. Children with this condition form the largest group for possible liver transplantation in the future; hence, stress should be laid on close attention to their nutrition.
Twenty-five patients with biliary atresia as cases and 25 age-matched children as controls were enrolled in the study from November 2010 to June 2012. Preoperatively, patients underwent standard investigations and anthropometric measurement (weight, height, and head circumference) assessment. Nutritional status (assessed with standard growth chart) was compared with control population, and children were divided into poor nutritional status and good nutritional status. Kasai's portoenterostomy was performed in all patients, and comparison was done between preoperative nutritional status with postoperative status of children and also between hepatic iminodiacetic acid (HIDA) scan-positive (patent bilioenteric pathway) children with HIDA scan-negative children. Postoperatively, after 12 weeks, the same anthropometric measurements were taken again, growth velocity (GV) was assessed, and children were divided into poor, average, and good GV.
Nutritional status of children with biliary atresia was significantly poor than that of control group. Postoperatively, children had better nutritional status than preoperative nutritional status, especially in HIDA scan-positive children. GV was also significantly better in those children in whom postoperative HIDA scan was positive.
Children with biliary atresia have poor nutritional status in comparison to normal population and require multifaceted approach to achieve adequate nutrition. Establishment of a patent bilioenteric pathway in these children improves their nutritional status and GV.
胆道闭锁患者存在营养消耗和生长发育迟缓的情况；“正常”的营养和维生素补充无法纠正这些缺陷。患有这种疾病的儿童是未来可能进行肝移植的最大群体；因此，应强调密切关注他们的营养状况。
2010年11月至2012年6月，本研究纳入了25例胆道闭锁患儿作为病例组，以及25例年龄匹配的儿童作为对照组。术前，患者接受了标准检查和人体测量（体重、身高和头围）评估。将营养状况（根据标准生长图表评估）与对照组进行比较，并将儿童分为营养状况差和营养状况良好两组。所有患者均接受了Kasai肝门空肠吻合术，并比较了儿童术前营养状况与术后状况，以及肝亚氨基二乙酸（HIDA）扫描阳性（胆肠通路通畅）儿童与HIDA扫描阴性儿童之间的情况。术后12周，再次进行相同的人体测量，评估生长速度（GV），并将儿童分为生长速度差、中等和良好三组。
胆道闭锁患儿的营养状况明显差于对照组。术后，患儿的营养状况优于术前，尤其是HIDA扫描阳性的患儿。术后HIDA扫描阳性的患儿生长速度也明显更好。
与正常人群相比，胆道闭锁患儿的营养状况较差，需要采取多方面的方法来实现充足的营养。在这些患儿中建立通畅的胆肠通路可改善他们的营养状况和生长速度。
