摘要
目的探讨儿童肝移植手术前后体重以及身高增长情况，评估患儿的营养不良状况及其与手术后时间的关系。方法选择2007年7月至2012年12月在上海交通大学医学院附属仁济医院进行儿童肝移植手术的5l例患儿为研究对象。根据2005年九省／市儿童体格发育调查数据为标准，分别定位每例患儿手术前后的体重、身高百分位数。定义体重低于同年龄、同性别参照人群第3百分位数值为体重低下；身高低于同年龄、同性别参照人群第3百分位数值为生长迟缓。对51例患儿肝移植术前及术后的生长发育指标采用x2检验进行比较。对术后4年内体重低下及生长迟缓情况进行分层对数线性分析，探讨肝移植前后儿童营养不良程度与手术后时间的关系。结果51例患儿男26例、女25例，年龄13个月～13岁，平均44．78个月。肝移植术前体重低下20例（39％），生长迟缓35例（69％）；肝移植术后体重低下5例（10％），生长迟缓14例（27％）；肝移植术前、术后的体重百分位数值差异有统计学意义（x^2=10．385，P=0．001）；手术前与手术后身高百分位数值差异也有统计学意义（x^2=15．710，P=0．000）。
Objective To evaluate the growth of children in weight and height before and after liver transplantation and the relation between malnutrition and postoperative time. Method Growth was assessed for children who received liver transplantation from July 2007 to December 2012 after operation during follow- up. Weight and height were measured for 51 children in May 30, 2013. Weight and height percentiles of each child were calculated in accordance with data surveying on physical development of children in nine provinces/municipalities. Underweight was defined as weight less than the third percentile of same age and sex groups. Growth retardation was defined as height less than the third percentile of same age and sex groups. Children were set into 2 groups （before liver transplantation group, after liver transplantation group）. The incidence of underweight and growth retardation were analyzed by ehi-square test. Children were divided into 4 groups according to the length of time from operation time to May 30, 2013 ： 1 year after liver transplantation （1 -365 days） ; 2 years after liver transplantation （366 -730 days） ; 3 years after liver transplantation（731 -1 095 days）; 4 years or more after liver transplantation （1 096-2 133 days）. The underweight and growth retardation were analyzed by hierarchical log linear model. Result The mean age of 51 children was 44. 78 months （ range 13 months to 13 years old） , 26 of them were male and 25 female. The number of children with underweight and growth retardation were 20 （ 39% ） and 35 （69%） respectivelybefore transplantation and were 5 （ 10% ） and 14 （27%） respectively after transplantation. There was a significant difference between underweight incidence before and after operation （ X^2 = 10. 385, P = 0. 001 ）. There was significant difference between growth retardation incidence before and after operation （X^2 = 15.710, P = 0. 000）. The subjects included 10 patients at 1 year after operation （underweight n = 3, growth retardation n =3）, 19 patients at 2 years （underweight n = 1, growth retardation n = 9）, 10 patients at 3 years （ underweight n = 1, growth retardation n = 2） , 12 patients at 4 years and above （ underweight n = 0, growth retardation n = 0）. Parameter analysis of hierarchical log linear estimates： underweight at 1 year = 0. 661 ,underweight at 2 years = - 0. 214, underweight at 3 years = 0. 119, underweight at 4 years and above = -0. 566. Growth retardation at l year =0. 282, at 2 years =0. 613, at 3 years =0. 051, at 4 years and above = -0. 946. Conclusion Compared with after liver transplantation, obvious malnutrition existed in patients before transplantation. Patients have the ability to catch-up growth after liver transplantation. Reduced effect of underweight occurred in second year after liver transplantation. Reduced effect of growth retardation occurred in third year after liver transplantation.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2014年第8期575-578,共4页
Chinese Journal of Pediatrics
基金
上海市卫生局重点联合攻关项目（2013ZYJB0001）
关键词
体重
生长
肝移植
儿童
Body weight
Growth
Liver transplantation
Child
