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一个专门为唇裂和/或腭裂婴儿设立的多学科生长与喂养诊所表明了干预的必要性。

A Dedicated Multidisciplinary Growth and Feeding Clinic for Infants with Cleft Lip and/or Palate Demonstrates Need for Intervention.

作者信息

Prezelski Kayla, Villarreal Acha Daniel, Ngo Tuong-Vi Cindy, Wilson Caitlin, Thrasher Vania, Trevino Kandi, Van't Slot Cortney, Hallac Rami R, Seaward James R, Kane Alex A

机构信息

Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Analytical Imaging and Modeling Center, Children's Health, Dallas, TX, USA.

出版信息

Cleft Palate Craniofac J. 2024 Jun 11:10556656241258687. doi: 10.1177/10556656241258687.

Abstract

OBJECTIVE

A Growth and Feeding Clinic (GFC) focused on early intervention around feeding routines in patients with cleft lip and/or palate (CL/P) was implemented.

DESIGN

This study assessed the effect of preoperative feeding interventions provided by the GFC.

SETTING

Tertiary academic center.

METHODS

This study evaluated patients with CL/P who were cared for by the GFC and a control group of patients with CL/P. Weight-for-age (WFA) Z-score of less than -2.00 was used as a cutoff to classify patients who were underweight during the preoperative period.

MAIN OUTCOME MEASURE

The number of underweight patients who were able to reach normal weight by the time of their cleft lip repair was used as the primary outcome measure.

RESULTS

Within both the GFC and control groups, 25% of patients with CL/P were underweight as determined by WFA Z-score. GFC patients who were underweight received more clinic visits ( < .001) and GFC interventions ( < .001) compared to GFC patients who were normal weight. At the time of cleft lip surgery, 64.1% of GFC underweight patients were normal weight compared to 31.8% of control group underweight patients ( = .0187).

CONCLUSION

This study showed that multidisciplinary care provided by the GFC was able to target preoperative nutritional interventions to the highest-risk patients, resulting in double the percentage of patients who were of normal weight at the time of their cleft lip repair. These results provide objective proof supporting the assertion that multidisciplinary team care of the infant with cleft leads to measurable improvement in outcomes.

摘要

目的

设立了一个生长与喂养诊所(GFC),专注于对唇腭裂(CL/P)患者的喂养习惯进行早期干预。

设计

本研究评估了GFC提供的术前喂养干预措施的效果。

地点

三级学术中心。

方法

本研究评估了由GFC护理的CL/P患者以及CL/P患者对照组。以年龄别体重(WFA)Z评分低于-2.00作为术前体重过轻患者的分类标准。

主要观察指标

以唇裂修复时能够达到正常体重的体重过轻患者数量作为主要观察指标。

结果

在GFC组和对照组中,根据WFA Z评分确定,25%的CL/P患者体重过轻。与体重正常的GFC患者相比,体重过轻的GFC患者接受了更多的门诊就诊(<0.001)和GFC干预(<0.001)。在唇裂手术时,64.1%的GFC体重过轻患者体重正常,而对照组体重过轻患者的这一比例为31.8%(P = 0.0187)。

结论

本研究表明,GFC提供的多学科护理能够针对最高风险患者进行术前营养干预,使唇裂修复时体重正常的患者比例增加了一倍。这些结果提供了客观证据,支持了唇裂婴儿的多学科团队护理可使治疗结果得到可测量改善这一论断。

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