AP-HP, Department of Neonatology, Armand-Trousseau Childrens Hospital, Paris, France
AP-HP, Service des Maladies Digestives de l'Enfant, Hôpital Universitaire Mère-enfant Robert-Debré, Paris, France.
Arch Dis Child. 2022 Jan;107(1):52-58. doi: 10.1136/archdischild-2020-320609. Epub 2021 Apr 16.
With advances in surgical and neonatal care, the survival of patients with oesophageal atresia (OA) has improved over time. Whereas a number of OA-related conditions (delayed primary anastomosis, anastomotic stricture and oesophageal dysmotility) may have an impact on feeding development and although children with OA experience several oral aversive events, paediatric feeding disorders (PFD) remain poorly described in this population. The primary aim of our study was to describe PFD in children born with OA, using a standardised scale. The secondary aim was to determine conditions associated with PFD.
The Feeding Disorders in Children with Oesophageal Atresia Study is a national cohort study based on the OA registry from the French National Network. Parents of children born with OA between 2013 and 2016 in one of the 22 participating centres were asked to complete the French version of the Montreal Children's Hospital Feeding Scale.
Of the 248 eligible children, 145 children, with a median age of 2.3 years (Q1-Q3 1.8-2.9, min-max 1.1-4.0 years), were included. Sixty-one children (42%) developed PFD; 13% were tube-fed (n=19). Almost 40% of children with PFD failed to thrive (n=23). The presence of chronic respiratory symptoms was associated with the development of PFD. Ten children with PFD (16%) had no other condition or OA-related complication.
PFD are common in children with OA, and there is no typical profile of patients at risk of PFD. Therefore, all children with OA require a systematic screening for PFD that could improve the care and outcomes of patients, especially in terms of growth.
随着外科和新生儿护理技术的进步,食管闭锁(OA)患者的存活率随时间推移而提高。尽管一些 OA 相关病症(延迟初次吻合、吻合口狭窄和食管动力障碍)可能会对喂养发育产生影响,并且 OA 患儿经历了多次口腔厌恶事件,但儿科喂养障碍(PFD)在该人群中的描述仍不完善。我们研究的主要目的是使用标准化量表描述患有 OA 的患儿的 PFD。次要目的是确定与 PFD 相关的条件。
《食管闭锁患儿喂养障碍研究》是一项全国性队列研究,基于法国国家网络的 OA 登记处。要求在 22 个参与中心之一出生的患有 OA 的儿童的父母在其 2013 年至 2016 年期间完成法语版蒙特利尔儿童医院喂养量表。
在 248 名符合条件的患儿中,纳入了 145 名患儿,中位年龄为 2.3 岁(四分位距 1.8-2.9,最小-最大 1.1-4.0 岁)。61 名患儿(42%)患有 PFD;13%(n=19)接受了管饲喂养。近 40%的 PFD 患儿生长不良(n=23)。存在慢性呼吸症状与 PFD 的发生相关。10 名患有 PFD(16%)的患儿无其他疾病或 OA 相关并发症。
PFD 在 OA 患儿中很常见,且没有特定的 PFD 高危患儿特征。因此,所有 OA 患儿均需要进行 PFD 的系统筛查,这可以改善患儿的护理和结局,尤其是在生长方面。