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经空气置换体描记法评估的单纯先天性腹壁裂患儿的早期生长和身体成分。

Early growth and body composition assessed by air displacement plethysmography in infants born with simple gastroschisis.

机构信息

Department of Surgery, Surgical NICU, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.

Clinical Research Unit, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.

出版信息

J Pediatr Surg. 2023 Apr;58(4):741-746. doi: 10.1016/j.jpedsurg.2022.11.005. Epub 2022 Nov 24.

Abstract

BACKGROUND

Gastroschisis is an abdominal wall malformation usually associated with impaired growth.

OBJECTIVE

To evaluate the growth and body composition of infants born with simple gastroschisis in a referral center.

METHODS

This was a single-center, prospective case series of infants with simple gastroschisis who were measured at birth, at discharge, and at 3 months. Body composition was assessed via air-displacement plethysmography at discharge and at 3 months. The results were compared with those reported for healthy infants at an equivalent gestational age.

RESULTS

Simple gastroschisis infants were lighter and smaller at birth and remained similar at 3 months. All anthropometric z scores decreased from birth to discharge, followed by an increase but not a full recovery toward 3 months. Overall, gastroschisis infants had a similar FM percentage, FM% (11.1 ± 4.7), but a lower FFM, FFM (2481 ± 478 g), at discharge. FM% (18.5 ± 5.3) decreased at 3 months, and FFM remained lower (3788 ± 722 g) but improved between the two exams. Boys had significantly more FFM than girls at both evaluations. The multiple regression analysis showed that male sex, prematurity, total parenteral nutrition duration, and exclusive breast milk diets were associated with differences in body composition.

CONCLUSIONS

Infants with simple gastroschisis cared for in a referral center experienced growth failure at discharge and showed a similar FM% but lower FFM than healthy infants. At 3 months, they exhibited smaller FM% and FFM, but FFM improved after the first exam, representing a better protein accretion.

TYPE OF STUDY

Prognostic.

LEVEL OF EVIDENCE

IV.

摘要

背景

先天性腹裂是一种腹壁畸形,通常与生长受限有关。

目的

评估在转诊中心出生的单纯性先天性腹裂婴儿的生长和身体成分。

方法

这是一项单中心、前瞻性病例系列研究,纳入了在出生、出院和 3 个月时接受测量的单纯性先天性腹裂婴儿。在出院和 3 个月时通过空气置换体积描记法评估身体成分。将结果与同等胎龄的健康婴儿的报告结果进行比较。

结果

单纯性先天性腹裂婴儿在出生时体重较轻、体型较小,3 个月时仍保持相似。所有的人体测量 Z 评分均从出生时下降,随后在出院时增加,但到 3 个月时并未完全恢复。总的来说,先天性腹裂婴儿在出院时的 FM 百分比(11.1±4.7)相似,但 FFM(2481±478g)较低。3 个月时 FM%(18.5±5.3)下降,FFM 仍然较低(3788±722g),但在两次检查之间有所改善。男孩在两次评估中均比女孩具有更多的 FFM。多元回归分析显示,男性、早产、全肠外营养持续时间和纯母乳喂养与身体成分的差异有关。

结论

在转诊中心接受治疗的单纯性先天性腹裂婴儿在出院时经历了生长不良,并且表现出与健康婴儿相似的 FM%,但 FFM 较低。在 3 个月时,他们表现出较小的 FM%和 FFM,但 FFM 在第一次检查后有所改善,表明蛋白质积累更好。

研究类型

预后。

证据水平

IV。

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