Cao Huiyan,Feng Jiexiong.Research advances of assessing nutritional status in children undergoing surgery[J].Journal of Clinical Pediatric Surgery,2023,22(03):291-295.[doi:10.3760/cma.j.cn101785-202202045-017]
手术患儿营养状况评估的研究进展
- Title:
- Research advances of assessing nutritional status in children undergoing surgery
- Keywords:
- Surgical Procedures; Operative; Malnutrition; Nutrition Assessment; Nutritional Requirements; Child
- 摘要:
- 儿童营养状况差不仅会对机体生长发育造成不可逆损伤,还会影响临床预后。尽管近年来临床对儿童营养的关注程度不断提高,管理流程不断完善,儿童营养不良的发生率逐年下降,但手术患儿因面临疾病和手术的双重打击,营养不良的发生率仍然较高,且手术患儿营养管理的不足可能加重这一趋势。本文介绍手术患儿营养状况、营养筛查工具的使用以及营养评估方法,以提高小儿外科医生对手术患儿营养状况的关注,加强手术患儿围手术期营养管理。
- Abstract:
- Poor nutritional status not only affects clinical prognosis,but also causes irreversible developmental damage in children.Despite heightened clinical attention to nutrition and improved managements in recent years,the overall incidence of childhood malnutrition has declined year by year.However,due to a double blow of disease and operation,children undergoing surgery face high nutritional risks and nutritional status is prone to deteriorate.Moreover,inadequate nutritional management may aggravate the problems.This review summarized current nutritional status of children undergoing surgery and using nutrition screening tools and nutrition evaluation methods to raise the attention and strengthen nutrition management during perioperative period.
参考文献/References:
[1] Bouma S.Diagnosing pediatric malnutrition[J].Nutr Clin Pract,2017,32(1):52-67.DOI:10.1177/0884533616671861.
[2] Galler JR,Bringas-Vega ML,Tang Q,et al.Neurodevelopmental effects of childhood malnutrition:a neuroimaging perspective[J].Neuroimage,2021,231:117828.DOI:10.1016/j.neuroimage.2021.117828.
[3] Mehta NM,Corkins MR,Lyman B,et al.Defining pediatric malnutrition:a paradigm shift toward etiology-related definitions[J].JPEN J Parenter Enteral Nutr,2013,37(4):460-481.DOI:10.1177/0148607113479972.
[4] McCarthy A,Delvin E,Marcil V,et al.Prevalence of malnutrition in pediatric hospitals in developed and in-transition countries:the impact of hospital practices[J].Nutrients,2019,11(2):236.DOI:10.3390/nu11020236.
[5] Lindberg L,Nhambongo I,Nhampossa T,et al.A qualitative study of mothers’health literacy related to malnutrition in under 5-year-old children in southern Mozambique[J].Public Health Nutr,2022,25(7):1947-1955.DOI:10.1017/S1368980021004365.
[6] 盛金叶,茅晓蒙,陆丽娜,等.儿童主观整体营养评估工具在住院儿童中的应用评价[C]//营养研究与临床实践--第十四届全国营养科学大会暨第十一届亚太临床营养大会、第二届全球华人营养科学家大会论文摘要汇编.南京:中国营养学会,2019:56.DOI:10.26914/c.cnkihy.2019.010087. Sheng JY,Mao XM,Lu LN,et al.Evaluations of children’s subjective global nutrition assessment tool in hospitalized children[C]//Nutrition Research and Clinical Practice-Summary of Papers of XIV National Nutrition Science Conference,XI Asia Pacific Clinical Nutrition Conference and Second Global Chinese Nutrition Scientists Conference.Nanjing:Chinese Nutrition Society,2019:56.DOI:10.26914/c.cnkihy.2019.010087.
[7] Abdelhadi RA,Bouma S,Bairdain S,et al.Characteristics of hospitalized children with a diagnosis of malnutrition:United States,2010[J].JPEN J Parenter Enteral Nutr,2016,40(5):623-635.DOI:10.1177/0148607116633800.
[8] 沈丽媛,洪莉.营养不良对危重症住院患儿临床结局的影响[J].交通医学,2020,34(4):407-411.DOI:10.19767/j.cnki.32-1412.2020.04.026. Shen LY,Hong L.Impact of malnutrition on clinical outcomes of critically ill hospitalized children[J].Med J Commun,2020,34(4):407-411.DOI:10.19767/j.cnki.32-1412.2020.04.026.
[9] Hecht C,Weber M,Grote V,et al.Disease associated malnutrition correlates with length of hospital stay in children[J].Clin Nutr,2015,34(1):53-59.DOI:10.1016/j.clnu.2014.01.003.
[10] Niseteo T,Hojsak I,Kola?ek S.Malnourished children acquire nosocomial infections more often and have significantly increased length of hospital stay[J].Clin Nutr,2020,39(5):1560-1563.DOI:10.1016/j.clnu.2019.06.022.
[11] Szostak-W?gierek D,Szamotulska K.Fetal development and risk of cardiovascular diseases and diabetes type 2 in adult life[J].Med Wieku Rozwoj,2011,15(3):203-215.
[12] Hock RS,Bryce CP,Fischer L,et al.Childhood malnutrition and maltreatment are linked with personality disorder symptoms in adulthood:results from a Barbados lifespan cohort[J].Psychiatry Res,2018,269:301-308.DOI:10.1016/j.psychres.2018.05.085.
[13] Penido RC,Isaac ML,Penido AB.Influence of malnutrition on the development of the central nervous system of malnourished children[J].Nutr Neurosci,2020,23(2):85-92.DOI:10.1080/1028415X.2018.1472962.
[14] Chen K,Liu CF,Liu XH,et al.Nutrition,cognition,and social emotion among preschoolers in poor,rural areas of south central China:status and correlates[J].Nutrients,2021,13(4):1322.DOI:10.3390/nu13041322.
[15] Calcaterra V,Cena H,Verduci E,et al.Nutritional surveillance for the best start in life,promoting health for neonates,infants and children[J].Nutrients,2020,12(11):3386.DOI:10.3390/nu12113386.
[16] Geng TT,Wang MY,Li X,et al.Birth weight modifies the relation between adulthood levels of insulin-like growth factor-1 and type 2 diabetes:a prospective cohort study[J].BMJ Open Diabetes Res Care,2021,9(1):e001885.DOI:10.1136/bmjdrc-2020-001885.
[17] Fall CHD,Kumaran K.Metabolic programming in early life in humans[J].Philos Trans R Soc Lond B Biol Sci,2019,374(1770):20180123.DOI:10.1098/rstb.2018.0123.
[18] Galler JR,Bryce CP,Zichlin ML,et al.Infant malnutrition is associated with persisting attention deficits in middle adulthood[J].J Nutr,2012,142(4):788-794.DOI:10.3945/jn.111.145441.
[19] Seneza C,McIsaac DI,Twagirumugabe T,et al.A prospective,cohort study of the effect of acute and chronic malnutrition on length of stay in children having surgery in Rwanda[J].Anesth Analg,2022,135(1):152-158.DOI:10.1213/ANE.0000000000005956.
[20] Saengnipanthkul S,Chongviriyaphan N,Densupsoontorn N,et al.Hospital-acquired malnutrition in paediatric patients:a multicentre trial focusing on prevalence,risk factors,and impact on clinical outcomes[J].Eur J Pediatr,2021,180(6):1761-1767.DOI:10.1007/s00431-021-03957-9.
[21] Pan LY,Liu YM,Feng Y,et al.Nutrition risk profile of 62408 inpatients based on electronic health records in a tertiary children’s hospital[J].Nutrition,2021,85:111137.DOI:10.1016/j.nut.2020.111137.
[22] Anderson BR,Blancha Eckels VL,Crook S,et al.The risks of being tiny:the added risk of low weight for neonates undergoing congenital heart surgery[J].Pediatr Cardiol,2020,41(8):1623-1631.DOI:10.1007/s00246-020-02420-0.
[23] Chinawa AT,Chinawa JM,Duru CO,et al.Assessment of nutritional status of children with congenital heart disease:a comparative study[J].Front Nutr,2021,8:644030.DOI:10.3389/fnut.2021.644030.
[24] Ross FJ,Radman M,Jacobs ML,et al.Associations between anthropometric indices and outcomes of congenital heart operations in infants and young children:an analysis of data from the Society of Thoracic Surgeons Database[J].Am Heart J,2020,224:85-97.DOI:10.1016/j.ahj.2020.03.012.
[25] Cohen J,Collins L,Gregerson L,et al.Nutritional concerns of survivors of childhood cancer:a "first world" perspective[J].Pediatr Blood Cancer,2020,67(Suppl 3):e28193.DOI:10.1002/pbc.28193.
[26] 颜莓,唐维兵,黄婕,等.恶性实体瘤儿童营养状况及影响因素研究[J].临床儿科杂志,2021,39(5):327-331.DOI:10.3969/j.issn.1000-3606.2021.05.002. Yan M,Tang WB,Huang J,et al.Nutritional status and influencing factors of children with solid malignant tumors[J].J Clin Pediatr,2021,39(5):327-331.DOI:10.3969/j.issn.1000-3606.2021.05.002.
[27] Murphy AJ,Hill RJ,Buntain H,et al.Nutritional status of children with clinical conditions[J].Clin Nutr,2017,36(3):788-792.DOI:10.1016/j.clnu.2016.05.014.
[28] 朱媛,高怡瑾,冯一,等.实体瘤患儿治疗期间营养状况及影响因素分析[J].临床小儿外科杂志,2022,21(1):36-40.DOI:10.3760/cma.j.cn.101785-202101003-007. Zhu Y,Gao YJ,Feng Y,et al.Nutritional status and influencing factors of children with solid tumors during treatment[J].J Clin Ped Sur,2022,21(1):36-40.DOI:10.3760/cma.j.cn.101785-202101003-007.
[29] Runco DV,Stanek JR,Yeager ND,et al.Malnutrition identification and management variability:an administrative database study of children with solid tumors[J].JPEN J Parenter Enteral Nutr,2022,46(7):1559-1567.DOI:10.1002/jpen.2329.
[30] Bierman SM,Peterson SJ,Chen YM.Identification,coding,and reimbursement of pediatric malnutrition at an urban academic medical center[J].Nutr Clin Pract,2018,33(5):640-646.DOI:10.1002/ncp.10064.
[31] Votto M,De Filippo M,Olivero F,et al.Malnutrition in eosinophilic gastrointestinal disorders[J].Nutrients,2020,13(1):128.DOI:10.3390/nu13010128.
[32] Ladd MR,Garcia AV,Leeds IL,et al.Malnutrition increases the risk of 30-day complications after surgery in pediatric patients with Crohn disease[J].J Pediatr Surg,2018,53(11):2336-2345.DOI:10.1016/j.jpedsurg.2018.04.026.
[33] Million M,Diallo A,Raoult D.Gut microbiota and malnutrition[J].Microb Pathog,2017,106:127-138.DOI:10.1016/j.micpath.2016.02.003.
[34] Iddrisu I,Monteagudo-Mera A,Poveda C,et al.Malnutrition and gut microbiota in children[J].Nutrients,2021,13(8):2727.DOI:10.3390/nu13082727.
[35] Cederholm T,Barazzoni R,Austin P,et al.ESPEN guidelines on definitions and terminology of clinical nutrition[J].Clin Nutr,2017,36(1):49-64.DOI:10.1016/j.clnu.2016.09.004.
[36] Leij-Halfwerk S,Verwijs MH,Van Houdt S,et al.Prevalence of protein-energy malnutrition risk in European older adults in community,residential and hospital settings,according to 22 malnutrition screening tools validated for use in adults ≥65 years:a systematic review and meta-analysis[J].Maturitas,2019,126:80-89.DOI:10.1016/j.maturitas.2019.05.006.
[37] Santos CAD,Rosa CDOB,Franceschini SDCC,et al.StrongKids for pediatric nutritional risk screening in Brazil:a validation study[J].Eur J Clin Nutr,2020,74(9):1299-1305.DOI:10.1038/s41430-020-0644-1.
[38] Bélanger V,McCarthy A,Marcil V,et al.Assessment of malnutrition risk in Canadian pediatric hospitals:a multicenter prospective cohort study[J].J Pediatr,2019,205:160-167.e6.DOI:10.1016/j.jpeds.2018.09.045.
[39] Pérez-Solís D,Larrea-Tamayo E,Menéndez-Arias C,et al.Assessment of two nutritional screening tools in hospitalized children[J].Nutrients,2020,12(5):1221.DOI:10.3390/nu12051221.
[40] Katsagoni CN,Cheirakaki O,Hatzoglou A,et al.Malnutrition in hospitalised children-an evaluation of the efficacy of two nutritional screening tools[J].Nutrients,2021,13(4):1279.DOI:10.3390/nu13041279.
[41] Huysentruyt K,Vandenplas Y,De Schepper J.Screening and assessment tools for pediatric malnutrition[J].Curr Opin Clin Nutr Metab Care,2016,19(5):336-340.DOI:10.1097/MCO.0000000000000297.
[42] Phillips CA,Bailer J,Foster E,et al.Implementation of an automated pediatric malnutrition screen using anthropometric measurements in the electronic health record[J].J Acad Nutr Diet,2019,119(8):1243-1249.DOI:10.1016/j.jand.2018.07.014.
[43] Bharadwaj S,Ginoya S,Tandon P,et al.Malnutrition:laboratory markers vs nutritional assessment[J].Gastroenterol Rep (Oxf),2016,4(4):272-280.DOI:10.1093/gastro/gow013.
相似文献/References:
[1]杜朝峻,丁力,胡英超,等.手术治疗婴幼儿法洛四联症83例[J].临床小儿外科杂志,2010,9(06):413.
DU Chao jun,DING Li,HU Ying chao,et al.Surgical treatment of Tetralogy of Fallot in infancy: Experiences of 83 cases.[J].Journal of Clinical Pediatric Surgery,2010,9(03):413.
[2]李勇,尹强,周小渔,等.术中胆道造影在先天性胆总管囊肿手术中的应用[J].临床小儿外科杂志,2010,9(06):430.
LI Yong,YIN Qiang,ZHOU Xiao yu,et al.The clinic application experience on intraoperative cholangiography in pediatric surgery.[J].Journal of Clinical Pediatric Surgery,2010,9(03):430.
[3]许芝林,王强,李琰,等.乙状结肠冗长症的术式选择探讨[J].临床小儿外科杂志,2010,9(06):432.
XU Zhi lin,WANG Qiang,LI Yan,et al.Initiatory exploration of the standard of surgical treatment methods for Dolichosigmoid.[J].Journal of Clinical Pediatric Surgery,2010,9(03):432.
[4]常绘文,沈振亚.右腋下小切口在儿童心内手术中的应用[J].临床小儿外科杂志,2010,9(06):439.
[5]胡明,施诚仁,严志龙.脐环小切口治疗婴幼儿腹盆腔疾病的探讨[J].临床小儿外科杂志,2010,9(06):471.
[6]丁勇,魏华,孔燕,等.横裁包皮岛状皮瓣法在尿道下裂治疗中的应用[J].临床小儿外科杂志,2010,9(06):474.
[7]江峰赵阳孙莲萍金惠明马杰.婴幼儿阻塞性脑积水两种手术方式的疗效比较[J].临床小儿外科杂志,2011,10(01):0.
JIANG Feng,ZHAO Yang,SUN Liang ping,et al.Endoscopic third ventricul ostomy versus ventricul operitoneal shunt:clinical study of obstructive hydro cephalus in infants.[J].Journal of Clinical Pediatric Surgery,2011,10(03):0.
[8]王伟程少文彭磊林忠勤张伟陈庆玉寇冬权.弹性髓内钉在儿童肱骨骨折中的应用[J].临床小儿外科杂志,2011,10(01):0.
WANG Wei,CHENG Shaowen,PENG Lei,et al.Application of elastic intramedullary nailing in pediatric humeral fractures.[J].Journal of Clinical Pediatric Surgery,2011,10(03):0.
[9]景登攀张根领孙蔓丽.改良Snodgrass术治疗尿道下裂疗效观察[J].临床小儿外科杂志,2011,10(01):0.
[10]陈快 黄金狮 戴康临 陶俊峰 赖勇强 陶强. 腹腔镜与开腹Ladd手术治疗新生儿肠旋转不良效果比较[J].临床小儿外科杂志,2011,10(02):128.
[J].Journal of Clinical Pediatric Surgery,2011,10(03):128.
备注/Memo
收稿日期:2022-2-1。
基金项目:国家自然科学基金(82071685)
通讯作者:冯杰雄,Email:fengjiexiong@126.com