[1]刘正伟,徐信兰,曾玉结,等.比较两种营养风险筛查工具在先心病病儿中的诊断效能研究[J].肠外与肠内营养杂志,2021,(01):30-34.[doi:10.16151/j.1007-810x.2021.01.007]
　LIU Zheng-wei,XU Xin-lan,ZENG Yu-jie,et al.Comparison of two nutritional risk screening tools in hospitalized children with congenital heart disease[J].PARENTERAL & ENTERAL NUTRITION,2021,(01):30-34.[doi:10.16151/j.1007-810x.2021.01.007]
点击复制

比较两种营养风险筛查工具在先心病病儿中的诊断效能研究
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年01期
页码:
30-34
栏目:
论著
出版日期:
2021-01-10

文章信息/Info

Title:
Comparison of two nutritional risk screening tools in hospitalized children with congenital heart disease
作者:
刘正伟; 徐信兰; 曾玉结; 吕云霞; 胡桂梅
广州市妇女儿童医疗中心，广东省结构性出生缺陷疾病研究重点实验室，外科部，广东广州 510623
Author(s):
LIU Zheng-wei;  XU Xin-lan;  ZENG Yu-jie;  L? Yun-xia;  HU Gui-mei
Department of Pediatric Surgery, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou 510623, Guangdong,China
关键词:
先天性心脏病 ; 儿童 ; 营养不良 ; 营养风险筛查 ; 诊断效能
Keywords:
Congenital Heart Disease;  Childre;  Malnutrition;  Nutritional Risk Screening;  Diagnostic Efficiency
分类号:
R473.72
DOI:
10.16151/j.1007-810x.2021.01.007
文献标志码:
A
摘要:
目的：比较儿科营养不良筛查工具（STAMP）与营养状况和生长风险筛查工具（STRONGkids）在先心病住院病儿营养风险筛查中的诊断效能。 方法：应用STAMP、STRONGkids对广州市妇女儿童医疗中心研究期间入住心血管科符合纳排标准的611例住院病儿的营养风险状况进行筛查。 结果：STAMP筛查出低、中、高度营养风险分别为 18.2%（111 例）、64.6%（395 例）、17.2%（105 例）；STRONGkids 筛查出低、中、高度营养风险分别为9.8%（60例）、72.3%（442例）、17.8%（109例）。以Z评分为金标准，611例先心病病儿中有49.1%（300例）存在营养不良问题，STAMP、STRONGkids两种工具的ROC曲线下面积分别为0.759、0.657。STAMP、STRONGkids的最佳截断值分别取4、3分时，其灵敏度、特异度、阳性预测值、阴性预测值分别为53.3%、92.3%、87%、67.2%；61.7%、64.3%、62.5%、63.5%。 结论：先心病住院病儿具有较高的营养不良发生率；两种筛查工具均能在一定程度上预测先心病病儿营养风险的发生，而 STAMP 对先心病病儿营养风险的诊断效能更为理想，STRONGkids 的敏感性较高，STAMP的特异度较高。
Abstract:
Objective: To compare the ability of the STAMP and STRONGkids to identify children with malnutrition on admission. Methods: A total of 611 hospitalized children who were admitted to the cardiovascular department of our hospital during the study period and met the eligibility criteria were assessed by the STAMP and STRONGkids. Results: According to the STAMP,18.2%(111 cases)of the patients were with low nutritional risk,64.6%(395 cases) medium risk and 17.2%(105 cases)o high risk; According to the STRONGkids,9.8%(60 cases)of the patients were with low nutritional risk,72.3%(442 cases) medium risk and 17.8%(109 cases) high risk. Using the Z-score as the gold standard,49.1% (300 cases) of the 611 children with congenital heart disease were malnourished. The area under the ROC curve of the STAMP and STRONGkids were 0.759 and 0.657 respectively. With the optimal cut-off value of 4 and 3 points respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the STAMP were 53.3%、92.3%、87%、67.2%; the corresponding values of the STRONGkids were 61.7%、64.3%、62.5%、63.5%. Conclusion: Hospitalized children with congenital heart disease have a higher incidence of malnutrition. Both of the two screening tools can be used for risk stratification, of which, STAMP was more accurate/ At optimal cut-off, the sensitivity of the STRONGkids was higher and the specificity of the STAMP was higher.

参考文献/References:


[1] 戚继荣, 莫绪明, 李 荣, 等.儿童营养风险及发育不良筛查工具用于先天性心脏病患儿围术期营养风险筛查. 中华临床营养杂志, 2014, 22(1):38-42.
[2] Vichayavilas PE, Skillman HE, Krebs NF. Nutrition in Congenital Heart Disease: Challenges, Guidelines and Nutritional Support. Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care,2014: 3201-3212.
[3] 中华医学会小儿外科学分会心胸外科学组,中华医学会肠外肠内营养学分会儿科学组 . 先天性心脏病患儿营养支持专家共识. 中华小儿外科杂志, 2016,37(1): 3-8.
[4] 黄 艳,仇安云,潘 键,等.STRONGkids营养风险筛查量表在消化科住院患儿中的应用.肠外与肠内营养,2019,26(2):95-98.
[5] 张 莉, 姚文英, 阐玉英, 等.营养风险筛查在普外科住院患儿中的应用.中华实用儿科临床杂志,2017,32(9):699-701.
[6] 张慧文, 顾 莺, 王慧美, 等. 营养状况和生长风险筛查工具用于先心病住院婴儿营养风险筛查的可行性研究. 护理学杂志,2016,31(4): 5-8.
[7] 邢 远, 颜 虹, 党少农. 婴幼儿营养不良现况及Z值评价方法参考标准的研究进展 . 国外医学(医学地理分册), 2009,30(4):208-211.
[8] Becker P, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Indicators recommended for the identification and documentation of pediatric malnutrition(undernutrition). Nutr Clin Pract, 2015,30(1): 147-161.
[9] Bouma S. Diagnosing Pediatric Malnutrition: Paradigm Shifts of Etiology-Related Definitions and Appraisal of the Indicators. Nutr Clin Pract, 2017,32(1): 52-67.
[10] 冯 升, 成 磊, 陆 华, 等.儿科营养不良评估筛查工具用于住院患儿营养风险筛查的诊断效能研究. 护理管理杂志, 2019,19(4): 233-236.
[11] Toole BJ, Toole LE, Kyle UG, et al. Perioperative nutritional support and malnutrition in infants and children with congenital heart disease. Congenit Heart Dis, 2014,9(1): 15-25.
[12] 郑 林, 王 旭, 潘 沱, 等. 婴幼儿先天性心脏病营养状况评估及其与术后预后的关系 . 中国分子心脏病学杂志, 2016,16(6): 1896-1900.
[13] 谢丽清, 洪 莉. 先天性心脏病患儿围手术期能量代谢影响因素研究进展. 国际儿科学杂志, 2017,44(11): 744-748.
[14] Shoykhet MK, Lowery KS, Vetterly CG. Malnutrition and Feeding Difficulties: Guidelines for Enteral and Parenteral Nutrition. Critical Care of Children with Heart Disease, 2010:671-677.
[15] 张慧文, 顾 莺, 王慧美, 等. 先天性心脏病患儿营养及喂养现状的调查研究. 中华护理杂志, 2016, 51(5): 578-582.
[16] Zhang J，Cui Y Q，Ma M Z，et al. Energy and ProteinRequirements in Children Undergoing Cardiopulmonary Bypass Surgery: Current Problems and Future Direction. JPEN, 2019,43(1): 54-62.
[17] 李 荣, 彭璐婷, 赵卫华, 等. 先天性心脏病住院患儿营养风险筛查及其临床意义. 中华小儿外科杂志, 2013,34(2): 101-104.
[18] 宋佳音, 郑 樱, 肖本熙, 等. 低龄先天性心脏病患儿营养风险与临床结局的关系研究. 中国全科医学, 2018,21(06): 698-701.
[19] Tsintoni A, Dimitriou G , Karatza AA. Nutrition of neonates with congenital heart disease: existing evidence, conflicts and concerns. J Matern Fetal Neonatal Med, 2020, 33(14):2487-2492.
[20] Lim CYS, Lim JKB, Moorakonda RB, et al. The Impact of Pre operative Nutritional Status on Outcomes Following Congenital Heart Surgery. Front Pediatr, 2019,7 :429
[21] Marino LV, Johnson MJ, Davies NJ, et al. Improving growth of infants with congenital heart disease using a consensus-based nutritional pathway. Clin Nutr, 2020,39(8) :2455-2462.
[22] 吴 珍, 富 智, 缪红军. 先天性心脏病新生儿围手术期营养支持的研究. 肠外与肠内营养, 2017,24(6): 365-368.
[23] Huysentruyt K, Devreker T, Dejonckheere J, et al. Accuracy of Nutritional Screening Tools in Assessing the Risk of Undernutrition in Hospitalized Children. J Pediatr Gastroenterol Nutr, 2015,61(2): 159-166.

相似文献/References:

[1]王 玉,杨中文,高 丽,等.补充维生素D对脓毒症儿童炎症反应的调节及其临床干预作用的应用[J].肠外与肠内营养杂志,2020,(04):215.[doi:10.16151/j.1007-810x.2020.04.006]
　WANG Yu,YANG Zhong-wen,GAO Li,et al.The effects of vitamin D supplementation on the regulation of inflammation and clinical outcomes in children with sepsis[J].PARENTERAL & ENTERAL NUTRITION,2020,(01):215.[doi:10.16151/j.1007-810x.2020.04.006]

备注/Memo

备注/Memo:
基金项目 ：广东省重点领域研发计划资助（2019B020227001） 作者简介 ：刘正伟，主管护师，护理硕士，从事小儿先心病护理研究。E-mail：582714083@qq.com 通讯作者 ：胡桂梅，E-mail：hgmgzch@126.com
更新日期/Last Update: 1900-01-01