儿童肠衰竭中的喂养挑战：来自三种不同评估工具的见解。
FEEDING CHALLENGES IN PEDIATRIC INTESTINAL FAILURE: INSIGHTS FROM THREE DIFFERENT INSTRUMENTS.
文献信息
| PMID | 42785553 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Alana V Signorini |
| 作者单位 | Post-Graduate Program of Child and Adolescent Health, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Brazil. Electronic address: alanass@gmail.com. |
| 期刊 | Clinical nutrition ESPEN |
| SCI 分区 | Q2 |
| IF | 3.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景与目的： 肠衰竭（IF）儿童中常报告喂养困难，这可能成为从肠外营养（PN）过渡到肠内自主喂养的重要障碍。适当的评估工具对于准确识别和管理喂养挑战至关重要。目的是使用三种互补的评估工具评估接受长期PN的IF儿童的喂养困难。
方法： 这项横断面研究纳入年龄6个月至18岁、接受PN超过两个月的IF儿童。排除患有口咽吞咽困难、严重神经系统疾病和严重先天性疾病的儿童。照护者完成结构化访谈，并应用三种工具：美国言语-语言-听力协会国家结果测量系统（ASHA-NOMS）、蒙特利尔儿童医院喂养量表（MCH-FS）和口腔运动评估量表（SOMA）。根据工具的心理测量学特性定义截断点。结果按年龄组进行分析。
结果： 共评估51名患者（中位年龄31.8个月，IQR 16.1-58.2；62.7%为男性）。至少一种工具识别出喂养异常的比例为52.9%。MCH-FS和ASHA-NOMS检测出31.4%的异常，SOMA检测出23.5%的异常，SOMA在36个月以下儿童中识别出的异常频率显著更高。
结论： 超过一半接受长期PN的IF儿童表现出喂养异常。联合工具可能提高喂养困难的识别，并指导个体化干预。
英文摘要
BACKGROUND & AIMS: Feeding difficulties are frequently reported in children with intestinal failure (IF) and may represent an important barrier to transition from parenteral nutrition (PN) to enteral autonomy. Appropriate assessment tools are essential for accurate recognition and management of feeding challenges. The objective was to evaluate feeding difficulties using three complementary assessment instruments in children with IF receiving prolonged PN.
METHODS: This cross-sectional study included children aged 6 months to 18 years with IF receiving PN for more than two months. Children with oropharyngeal dysphagia, severe neurological disease and severe congenital disorders were excluded. Caregivers completed a structured interview, and three instruments were applied: American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS), Montreal Children's Hospital Feeding Scale (MCH-FS), and Schedule for Oral Motor Assessment (SOMA). Cutoff points were defined according to instrument psychometric properties. Results were analyzed by age groups.
RESULTS: Fifty-one patients were evaluated (median age 31.8 months, IQR 16.1-58.2; 62.7% male). Feeding abnormalities identified by at least one instrument were present in 52.9% of participants. Abnormalities were detected in 31.4% by MCH-FS and ASHA-NOMS, and 23.5% by SOMA, which identified a significantly higher frequency of abnormalities in children younger than 36 months.
CONCLUSION: More than half of children with IF receiving prolonged PN showed feeding abnormalities. Combined tools may improve identification of feeding difficulties and guide individualized interventions.