需体外循环手术干预的先天性心脏病婴幼儿的营养评估

左茜; 苏洁; 陶柯宏; 周思敏; 刘双飞; 薛超; 韩跃虎

doi:10.12125/j.chj.202305085

需体外循环手术干预的先天性心脏病婴幼儿的营养评估

Nutritional assessment of infants with congenital heart disease requiring surgical intervention with extracorporeal circulation

摘要

摘要:
目的调查需体外循环手术干预的先天性心脏病婴幼儿的营养状况。
方法连续收集2021年1月～2022年11月在空军军医大学西京医院心血管外科拟行体外循环手术的479例先天性心脏病婴幼儿（年龄0岁～3岁）的临床资料，收集身高、体质量、疾病类型、诊疗结果和住院天数（HOD）等信息。在营养评估过程中选择与WHO的标准进行对比，并采用Z评分来评价患儿的营养状况，包括年龄别身高Z评分（HAZ)、年龄别体质量Z评分（WAZ)和身高别体质量Z评分（WHZ)，分析营养不良相关因素与患儿HOD的相关性。
结果生长迟缓（HAZ<-2）、低体质量（WAZ<-2）和消瘦（WHZ<-2）三种营养不良情况分别占16.1%、12.6%和9.0%。其中婴儿期的生长迟缓、低体质量和消瘦三种营养不良情况分别占25.5%、34.0%和14.8%，幼儿期的生长迟缓、低体质量和消瘦三种营养不良情况分别占7.7%、1.2%和6.2%，营养不良的情况与患儿的性别无关。在相关性分析中WAZ、HAZ、WHZ和白蛋白（alumin，ALU）与HOD呈负相关（均P<0.01）。
结论需体外循环手术干预的先天性心脏病婴幼儿营养不良的发生率较高，尤其是处于婴儿期的先心病患儿，营养不良可导致该群体患儿HOD延长。

Abstract:
AIM To evaluate the nutritional status of infants and children with congenital heart disease who need cardiopulmonary bypass surgery. Methods Clinical data were collected consecutively from January 2021 to November 2022 from 479 infants and children (aged 0 to 3 years) with congenital heart disease who were proposed for cardiopulmonary bypass surgery at the Cardiovascular Surgery Department of the Air Force Military Medical University, and information on height, weight, type of disease, outcome of treatment and number of days in hospital were collected.
METHODS Clinical data were collected consecutively from January 2021 to November 2022 from 479 infants and children (aged 0 to 3 years) with congenital heart disease who were proposed for cardiopulmonary bypass surgery at the Cardiovascular Surgery Department of the Air Force Military Medical University, and information on height, weight, type of disease, outcome of treatment and number of days in hospital were collected. During the nutritional assessment we chose to compare with WHO criteria and used Z scores: height-for-age Z score (HAZ), weight-for-age Z score (WAZ) and weight-for-height Z score (WHZ), to evaluate the nutritional status of the children and to analyse the impact of malnutrition on hospitalisation days.
RESULTS Growth retardation (HAZ<-2), low body mass (WAZ<-2), and emaciation (WHZ<-2) account for 16.1%, 12.6%, and 9.0%, respectively. Among them, growth retardation, low body mass, and weight loss in infancy accounted for 25.5%, 34.0%, and 14.8%, respectively, while growth retardation, low body mass, and weight loss in early childhood accounted for 7.7%, 1.2%, and 6.2%, respectively. Malnutrition was not related to the gender of the child. In correlation analysis, WAZ, HAZ, WHZ, and albumin showed a negative correlation with hospital stay (P<0.01). CONLUSION There is a high incidence of malnutrition in children with congenital heart disease. Especially in children with congenital heart disease in infancy, malnutrition can lead to prolonged hospitalization days.

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