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影响短肠综合征患儿心理行为发育的危险因素分析

Analysis of risk factors affecting psycho-behavioural development in children with short bowel syndrome.

作者信息

Wang Yue, Yu Li, Zheng Ruifei, Lv Xiaofeng, Zhang Jie, Jiang Weiwei, Tang Weibing

机构信息

Department of Neonatal Surgeries, Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Pediatr Surg Int. 2025 Jun 20;41(1):182. doi: 10.1007/s00383-025-06067-x.

Abstract

PURPOSE

The aim of this study is to follow up the psycho-behavioural development of children with SBS and to analyse the influencing factors affecting the children's psycho-behavioural development.

METHODS

Clinical information about 86 children with SBS was retrospectively collected through the hospital electronic medical record system. The ASQ-3 was used to assess the psycho-behavioural developmental outcomes of the children. Spearman's correlation coefficient, Kruskal Wallis H test, logistic regression analysis were used to find the risk factors affecting the psycho-behavioural development of the children through SPSS 27.0 statistical software.

RESULTS

Total bilirubin level was an influencing factor in gross motor (OR = 1.013, p = 0.010) and fine motor development (OR = 1.012, p = 0.044). ALT (OR = 1.007, p = 0.041) and AST (OR = 0.995, p = 0.021) were the influencing factors of gross motor development. High direct bilirubin (OR = 1.018, p = 0.034) was a risk factor for fine motor development. The presence or absence of IFALD (OR = 5.883, p = 0.034) during hospitalisation affected children's communication development. Preservation of the ileocecal junction during surgeries was beneficial for the development of communication (OR = 0.138, p = 0.007), problem-solving (OR = 0.117, p = 0.003), and personal-socialisation (OR = 0.119, p < 0.001). Absence of sepsis (OR = 0.227, p = 0.040) was a protective factor for the personal-socialisation development of the children. Retinol-binding protein was a protective factor in the communication (OR = 0.842, p = 0.012) and personal-socialisation (OR = 0.896, p = 0.014) domains of the children.

CONCLUSION

Our study finds a possible association between the liver function, nutritional status, retention of the ileocecal junction during surgeries and psycho-behavioural development in children with SBS, providing recommendations for future clinical interventions and treatments.

摘要

目的

本研究旨在随访短肠综合征(SBS)患儿的心理行为发育情况,并分析影响患儿心理行为发育的因素。

方法

通过医院电子病历系统回顾性收集86例SBS患儿的临床资料。采用年龄与发育进程问卷第3版(ASQ-3)评估患儿的心理行为发育结局。通过SPSS 27.0统计软件,采用Spearman相关系数、Kruskal Wallis H检验、logistic回归分析来寻找影响患儿心理行为发育的危险因素。

结果

总胆红素水平是影响大运动(OR = 1.013,p = 0.010)和精细运动发育(OR = 1.012,p = 0.044)的因素。谷丙转氨酶(ALT,OR = 1.007,p = 0.041)和谷草转氨酶(AST,OR = 0.995,p = 0.021)是大运动发育的影响因素。高直接胆红素(OR = 1.018,p = 0.034)是精细运动发育的危险因素。住院期间是否存在肠内营养相关性肝病(IFALD,OR = 5.883,p = 0.034)影响患儿的沟通发育。手术中保留回盲部对沟通发育(OR = 0.138,p = 0.007)、问题解决能力(OR = 0.117,p = 0.003)和个人社交能力(OR = 0.119,p < 0.001)的发育有益。无败血症(OR = 0.227,p = 0.040)是患儿个人社交能力发育的保护因素。视黄醇结合蛋白是患儿沟通(OR = 0.842,p = 0.012)和个人社交(OR = 0.896,p = 0.014)领域的保护因素。

结论

我们的研究发现肝功能、营养状况、手术中回盲部的保留与SBS患儿的心理行为发育之间可能存在关联,为未来的临床干预和治疗提供了建议。

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