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经搅拌的管饲与商业配方:哪种更适合胃造口喂养的儿童?

Blenderised Tube Feeds vs. Commercial Formula: Which Is Better for Gastrostomy-Fed Children?

机构信息

School of Women's and Children's Health, University of New South Wales, Sydney, NSW 2052, Australia.

Department of Nutrition and Dietetics, Sydney Children's Hospital, Randwick, NSW 2031, Australia.

出版信息

Nutrients. 2022 Jul 29;14(15):3139. doi: 10.3390/nu14153139.

Abstract

Blenderised tube feeds (BTF) have become a popular alternative to commercial formula (CF) for enterally fed children. This study sought to compare gastrointestinal (GI) symptoms, GI inflammation, and stool microbiome composition between children receiving BTF or CF. This prospective cohort study involved 41 gastrostomy-fed children, aged 2-18 years, receiving either BTF ( = 21) or CF ( = 20). The Paediatric Quality of Life Inventory Gastrointestinal Symptoms Scale (GI-PedsQL) was used to compare GI symptoms between the groups. Anthropometric data, nutritional intake, nutritional blood markers, faecal calprotectin levels, stool microbiota, and parental satisfaction with feeding regimen were also assessed. Caregivers of children on BTF reported greater GI-PedsQL scores indicating significantly fewer GI symptoms (74.7 vs. 50.125, = 0.004). Faecal calprotectin levels were significantly lower for children receiving BTF compared to children on CF (33.3 mg/kg vs. 72.3 mg/kg, = 0.043) and the BTF group had healthier, more diverse gut microbiota. Subgroup analysis found that 25% of caloric intake from BTF was sufficient to improve GI symptoms. The CF group had better body mass index (BMI) z-scores (-0.7 vs. 0.5, = 0.040). Although growth was poorer in children receiving only BTF in comparison to the CF group, this was not seen in children receiving partial BTF. A combination of BTF and CF use may minimise symptoms of tube feeding whilst supporting growth.

摘要

经搅拌机处理的管饲(BTF)已成为肠内喂养儿童替代商业配方(CF)的热门选择。本研究旨在比较接受 BTF 或 CF 的儿童的胃肠道(GI)症状、GI 炎症和粪便微生物组组成。这项前瞻性队列研究涉及 41 名接受胃造口术喂养的 2-18 岁儿童,其中 21 名接受 BTF,20 名接受 CF。使用儿科生活质量量表胃肠道症状评分(GI-PedsQL)比较两组之间的 GI 症状。还评估了人体测量数据、营养摄入量、营养血液标志物、粪便钙卫蛋白水平、粪便微生物群和喂养方案的父母满意度。接受 BTF 的儿童的 caregivers 报告 GI-PedsQL 评分更高,表明 GI 症状明显减少(74.7 与 50.125, = 0.004)。与接受 CF 的儿童相比,接受 BTF 的儿童的粪便钙卫蛋白水平显著降低(33.3 毫克/千克与 72.3 毫克/千克, = 0.043),BTF 组的肠道微生物群更健康、更多样化。亚组分析发现,BTF 提供的 25%热量足以改善 GI 症状。CF 组的体重指数(BMI)z 评分更好(-0.7 与 0.5, = 0.040)。尽管与 CF 组相比,仅接受 BTF 的儿童的生长较差,但在接受部分 BTF 的儿童中并未观察到这种情况。BTF 和 CF 联合使用可能会减轻管饲的症状,同时支持生长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd6d/9370549/4cbf87aadbb1/nutrients-14-03139-g001.jpg

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