...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Diagnosis and treatment of feeding disorders in children with developmental disabilities.
【24h】

Diagnosis and treatment of feeding disorders in children with developmental disabilities.

机译：发育障碍儿童的进食障碍的诊断和治疗。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVES: To determine the results of diagnostic evaluation and the effects of nutritional intervention on energy consumption, weight gain, growth, and clinical status of children with neurodevelopmental disabilities and suspected feeding disorders. METHODS: We studied 79 children with moderate to severe motor or cognitive dysfunction (male:female, 38:41; age, 5.8 +/- 3.7 years) who were referred for diagnosis and treatment of feeding or nutritional problems. Initial assessments included a 3-day calorie intake record, videofluoroscopic swallowing study (VFSS), 24-hour intraesophageal pH monitoring, milk scintigraphy, and esophagogastroduodenoscopy. RESULTS: These studies demonstrated gastroesophageal reflux (GER) with or without aspiration in 44 of 79 patients (56%), oropharyngeal dysphagia in 21 (27%), and aversive feeding behaviors in 14 (18%). Diagnosis-specific approaches included medical GER therapy in 20 patients (25%), fundoplication plus gastrostomy tube (GT) in 18 (23%), oral supplements in 17 (22%), feeding therapy only in 14 (18%), and GT only in 10 (13%). After 24.6 +/- 3.0 months, relative calorie intake, expressed as intake (kcal/d)/recommended daily allowance (RDA, kcal/d), improved significantly (initial:final = 0.78 +/- 0.36:1.23 +/- 0.27). The z scores increased significantly for both weight (initial:final = -2.80 +/- 1.33:-0.81 +/- 0.69) and height (-3.14 +/- 0.98:-2.00 +/- 0.67). Improved subcutaneous tissue stores were demonstrated by increased thickness of both subscapular skinfolds (change = 71% +/- 26%) and triceps skinfolds (38% +/- 17%). After nutritional intervention, the acute care hospitalization rate, compared with the 2-year period before intervention, decreased from 0.4 +/- 0.18 to 0.15 +/- 0.06 admissions per patient-year and included only 3 admissions (0.02 per patient-year) related to feeding problems. CONCLUSIONS: In children with developmental disabilities, diagnosis-specific treatment of feeding disorders results in significantly improved energy consumption and nutritional status. These data also indicate that decreased morbidity (reflected by a lower acute care hospitalization rate) may be related, at least in part, to successful management of feeding problems. Our results emphasize the importance of a structured approach to these problems, and we propose a diagnostic and treatment algorithm for children with developmental disabilities and suspected feeding disorders.children, developmental disabilities, fundoplication, gastroesophageal reflux, gastrostomy, hospitalization, nutrition.
机译：目的：确定诊断评估的结果以及营养干预对神经发育障碍和可疑进食障碍儿童的能量消耗，体重增加，生长和临床状况的影响。方法：我们研究了79名患有中度至重度运动或认知功能障碍的儿童（男：女，38:41;年龄，5.8 +/- 3.7岁），他们被诊断和治疗了喂养或营养问题。初步评估包括3天的卡路里摄入记录，视频透视吞咽研究（VFSS），24小时食管内pH监测，乳腺闪烁显像和食管胃十二指肠镜检查。结果：这些研究表明，在79例患者中有44例（56％）有或无误胃食管反流（GER），有21例（27％）有口咽性吞咽困难，有14例（18％）有厌食行为。诊断专用方法包括20例患者（25％）的医学GER治疗，18例（23％）的胃底折叠加胃造口术（GT），17例（22％）的口服补充剂，14例（18％）的仅进食疗法以及GT仅占10（13％）。 24.6 +/- 3.0个月后，相对卡路里摄入量（以摄入量（kcal / d）/建议的每日摄入量（RDA，kcal / d）表示）显着改善（初始：最终= 0.78 +/- 0.36：1.23 +/- 0.27 ）。体重（初始：最终= -2.80 +/- 1.33：-0.81 +/- 0.69）和身高（-3.14 +/- 0.98：-2.00 +/- 0.67）的z得分均显着增加。肩cap下皮褶的厚度增加（变化= 71％+/- 26％）和三头肌皮褶的厚度（38％+/- 17％）证明皮下组织存储得到改善。营养干预后，与干预前的2年相比，急诊住院率从每位患者年的0.4 +/- 0.18下降至0.15 +/- 0.06，仅包括3位患者（每位患者每年0.02）与喂养问题有关。结论：在发育障碍儿童中，针对诊断的进食障碍治疗可以显着改善能量消耗和营养状况。这些数据还表明，发病率的下降（反映出较低的急诊住院率）可能至少部分与成功解决喂养问题有关。我们的研究结果强调了针对这些问题采取结构化方法的重要性，我们提出了针对患有发育障碍和可疑进食障碍的儿童的诊断和治疗算法。儿童，发育障碍，胃底折叠术，胃食管反流，胃造口术，住院，营养。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号