Department of Pediatrics, Division of Gastroenterology, University of Minnesota, Minneapolis, MN.
Department of Clinical Nutrition, Children's Wisconsin, Milwaukee.
J Pediatr Gastroenterol Nutr. 2021 Mar 1;72(3):442-445. doi: 10.1097/MPG.0000000000002961.
We aimed to characterize the prevalence of pediatric feeding disorder (PFD) in short bowel syndrome (SBS) and study factors contributing to the persistence of PFD.
Single-center retrospective study of patients diagnosed with SBS at age 6 months or younger. Data were collected in 3-month intervals through age 2 years, and every 6 months through age 4 years. Demographic information, anthropometric data, and details regarding nutrition support were recorded and analyzed.
We reviewed 28 patients. Of the 21 patients who were weaned off parenteral nutrition, 57.1%, 81.0%, 90.5%, and 100.0% achieved this by 12, 24, 36, and 48 months of age, respectively. Of the 13 patients who were weaned off enteral nutrition, 30.8%, 69.2%, 76.9%, and 100.0% achieved this by 12, 24, 36, and 48 months, respectively.
The prevalence of PFD was 100.0%, 76.5%, 68.8%, and 70.0% at 1, 2, 3, and 4 years of age, respectively. All patients who exhibited resolution of PFD had an underlying etiology of necrotizing enterocolitis. Median small bowel percentage remaining was greater in patients who exhibited resolution of PFD compared to those who did not. Except for the group of patients seen at 4 years of age, a larger percentage of patients with vomiting/history of requirement of postpyloric feeds were seen among patients with PFD compared to those without PFD.
PFD is prevalent in children with SBS. Although prevalence decreases over time, children with PFD will continue to require more medical attention than children that do not.
本研究旨在明确短肠综合征（SBS）患儿中儿科喂养障碍（PFD）的流行情况，并探讨导致 PFD 持续存在的相关因素。
本研究为单中心回顾性研究，纳入年龄<6 个月确诊 SBS 的患儿。研究于患儿 6 个月龄时开始，此后每 3 个月随访一次至 2 岁，之后每 6 个月随访一次至 4 岁。收集患儿的人口统计学资料、体格检查数据及营养支持相关信息。
本研究共纳入 28 例患儿。21 例患儿成功脱离肠外营养，分别于 12、24、36、48 月龄时达到这一目标（57.1%、81.0%、90.5%、100.0%）。13 例患儿成功脱离肠内营养，分别于 12、24、36、48 月龄时达到这一目标（30.8%、69.2%、76.9%、100.0%）。
1、2、3、4 岁时 PFD 的发生率分别为 100.0%、76.5%、68.8%、70.0%。所有 PFD 缓解的患儿均存在坏死性小肠结肠炎这一潜在病因。PFD 缓解组患儿的小肠剩余比例中位数大于未缓解组。除 4 岁组外，PFD 患儿中呕吐/既往需经幽门后喂养的患儿比例高于非 PFD 患儿。
PFD 在 SBS 患儿中较为常见。尽管 PFD 的发生率随时间推移而降低，但 PFD 患儿需要更多的医疗关注。
