Zhao Jixun, Qiu Yuyang, Wang Huiqun
School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 561113, China; Department of Clinical Nutrition, Guizhou Rehabilitation Hospital, Guiyang, 550019, China.
Department of Emergency Intensive Care Unit, The Second People's Hospital of Guiyang, Guiyang, 550081, China.
Clin Nutr ESPEN. 2025 Feb;65:382-389. doi: 10.1016/j.clnesp.2024.12.018. Epub 2024 Dec 20.
Although the primary impairment involved in Cerebral palsy (CP) is motor function, malnutrition is also common. However, there is a lack of tool recommendations for early malnutrition risk screening in children with CP, and the means of nutritional intervention for children with CP are also limited.
This study systematically searched the literature about clinical nutrition related content of cerebral palsy in Pubmed, MEDLINE, Embase, and the Cochrane Library in Jan 2024 and by hand searching, and we checked reference lists and citations to identify additional studies. Search terms include cerebral palsy, children, diagnosis, prediction, malnutrition, nutritional risk screening, nutritional assessment, nutritional support. Additions are marked in red in the modified version.
The timing of diagnosis of CP has been moving forward, and some new diagnostic tools have been developed. Nutritional status is correlated with regional economic level, but there is still a malnutrition rate of nearly 30 % in developed countries. Severe restrictions in terms of gross motor function, swallowing dysfunction, feeding difficulties, cognitive impairment, and insufficient energy intake are common risk factors for malnutrition in children with CP. Z-score should be calculated in combination with measurement indicators in the assessment of physical development of children with CP. The nutritional outcomes of children with CP can be improved by various means, including diversified a Nutrition Support Team (NST) interventions.
The incidence of malnutrition in children with CP is high, which needs to be paid more attention. More effective malnutrition risk screening tools need to be developed for children with CP to guide the implementation of comprehensive and personalized nutritional interventions and improve malnutrient-related outcomes.
尽管脑瘫（CP）的主要损害是运动功能，但营养不良也很常见。然而，目前缺乏针对脑瘫患儿早期营养不良风险筛查的工具推荐，且脑瘫患儿的营养干预手段也有限。
本研究于2024年1月在Pubmed、MEDLINE、Embase和Cochrane图书馆系统检索有关脑瘫临床营养相关内容的文献，并通过手工检索，同时查阅参考文献列表和引用文献以识别其他研究。检索词包括脑瘫、儿童、诊断、预测、营养不良、营养风险筛查、营养评估、营养支持。修改版中新增内容用红色标注。
脑瘫的诊断时间已提前，并且已经开发了一些新的诊断工具。营养状况与地区经济水平相关，但发达国家仍有近30%的营养不良率。粗大运动功能严重受限、吞咽功能障碍、喂养困难、认知障碍和能量摄入不足是脑瘫患儿营养不良的常见危险因素。在评估脑瘫患儿身体发育时应结合测量指标计算Z评分。通过多种手段，包括多元化的营养支持团队（NST）干预，可以改善脑瘫患儿的营养结局。
脑瘫患儿营养不良的发生率较高，需要更多关注。需要为脑瘫患儿开发更有效的营养不良风险筛查工具，以指导实施全面、个性化的营养干预并改善与营养不良相关的结局。
