住院患儿营养风险筛查的研究进展

doi:10.11852/zgetbjzz2023-1212

摘要/Abstract

摘要： 营养不良是儿童死亡的重要原因,营养风险筛查可以初步筛查因为营养因素而导致不良临床结局的患儿,但是目前国际上还没有统一的筛查工具,这可能会影响患儿愈后,增加家庭负担。本文将对近几年住院患儿营养风险筛查的相关研究进行综述,进一步协助找到适合儿童营养风险筛查的工具。

关键词: 营养风险, 营养筛查, 儿童营养不良

Abstract: Malnutrition is an important cause of death in children. Nutritional risk screening can initially screen children with poor clinical outcomes due to nutritional factors. However, there is no unified screening tool over the world at present, which may affect the recovery of children and increase the family burden. Malnutrition is an important cause of death in children. This review combs related researches on nutritional risk screening in children in recent years, in order to help find suitable nutritional risk screening tools for children.

Key words: nutritional risk, nutritional screening, child malnutrition

中图分类号:

陈巧玲, 陆韦. 住院患儿营养风险筛查的研究进展[J]. 中国儿童保健杂志, 2024, 32(6): 653-660.

CHEN Qiaoling, LU Wei. Research progress of nutritional risk screening in hospitalized children[J]. Chinese Journal of Child Health Care, 2024, 32(6): 653-660.

参考文献

[1] Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002[J]. Clin Nutr, 2003, 22(4): 415-421.
[2] Maghraby MK, Li B, Chi L, et al. Extracellular vesicles isolated from milk can improve gut barrier dysfunction induced by malnutrition[J]. Sci Rep, 2021, 11(1): 7635.
[3] Menalu MM, Bayleyegn AD, Tizazu MA, et al. Assessment of prevalence and factors associated with malnutrition among under-five children in Debre Berhan Town, Ethiopia[J]. Int J Gen Med, 2021, 14: 1683-1697.
[4] Ghodsi D, Omidvar N, Nikooyeh B, et al. Effectiveness of community nutrition-specific interventions on improving malnutrition of children under 5 years of age in the eastern Mediterranean region: A systematic review and Meta-analysis[J]. Int J Environ Res Public Health, 2021, 18(15):7844.
[5] Hasan MT, Soares Magalhaes RJ, Williams GM, et al. Long-term changes in childhood malnutrition are associated with long-term changes in maternal BMI: Evidence from Bangladesh, 1996-2011[J]. Am J Clin Nutr, 2016, 104(4): 1121-1127.
[6] Taipa-Mendes AM, Amaral TF, Gregorio M. Undernutrition risk and nutritional screening implementation in hospitals: Barriers and time trends(2019-2020)[J]. Clin Nutr ESPEN, 2021, 45: 192-199.
[7] 国民营养计划(2017-2030年)[J]. 营养学报, 2017, 39(4): 315-320.
National Nutrition Plan(2017-2030)[J]. Chinese Journal of Nutrition, 2017, 39(4): 315-320.(in Chinese)
[8] Klanjšek P, Pajnkihar M, Marcun Varda N, et al. Development and validation of a new screening tool with non-invasive indicators for assessment of malnutrition risk in hospitalised children[J]. Children(Basel), 2022, 9(5):731.
[9] Hulst JM, Zwart H, Hop WC, et al. Dutch national survey to test the STRONGkids nutritional risk screening tool in hospitalized children[J]. Clin Nutr, 2010, 29(1): 106-111.
[10] Maciel JRV, Nakano EY, Carvalho KMB, et al. STRONGkids validation: Tool accuracy[J]. J Pediatr(Rio J), 2020, 96(3): 371-378.
[11] Spagnuolo MI, Liguoro I, Chiatto F, et al. Application of a score system to evaluate the risk of malnutrition in a multiple hospital setting[J]. Ital J Pediatr, 2013, 39: 81.
[12] Durakbasa CU, Fettahoglu S, Bayar A, et al. The prevalence of malnutrition and effectiveness of STRONGkids tool in the identification of malnutrition risks among pediatric surgical patients[J]. Balkan Med J, 2014, 31(4): 313-321.
[13] Marginean O, Pitea AM, Voidazan S, et al. Prevalence and assessment of malnutrition risk among hospitalized children in Romania[J]. J Health Popul Nutr, 2014, 32(1): 97-102.
[14] 应明媚, 舒信显, 陈美婷, 等. STRONGkids筛查对基层医院住院患儿营养风险的预测价值及与患儿临床结局的相关性[J]. 中国妇幼保健, 2021, 36(24): 5742-5745.
Ying ML, Shu XX, Chen MT, et al. Predictive value of STRONGkids screening for nutritional risk in children hospitalized in primary hospitals and its correlation with clinical outcomes of children[J]. Chinese Maternal and Child Health Care, 2021, 36(24): 5742-5745.(in Chinese)
[15] Castro JDS, Santos CAD, Rosa COB, et al. STRONGkids nutrition screening tool in pediatrics: An analysis of cutoff points in Brazil[J]. Nutr Clin Pract, 2022, 37(5): 1225-1232.
[16] Santos CAD, Rosa COB, Franceschini S, et al. Nutrition risk assessed by STRONGkids predicts longer hospital stay in a pediatric cohort: A survival analysis[J]. Nutr Clin Pract, 2021, 36(1): 233-240.
[17] Goncalves LV, Oliveira AG, Barracosa M, et al. Nutritional risk and malnutrition in paediatrics: From anthropometric assessment to strongkids(R) screening tool[J]. Acta Med Port, 2023, 36(5): 309-316.
[18] Tuokkola J, Hilpi J, Kolho KL, et al. Nutritional risk screening-a cross-sectional study in a tertiary pediatric hospital[J]. J Health Popul Nutr, 2019, 38(1): 8.
[19] 石倩, 杨军红, 张凯. 两种营养风险筛查工具在儿童糖尿病住院患者中的诊断效能分析[J]. 现代诊断与治疗, 2022, 33(1): 118-120.
Shi Q, Yang JH, Zhang K. Diagnostic efficacy of two nutritional risk screening tools in hospitalized children with diabetes mellitus[J]. Modern Diagnosis & Therapy, 2022, 33(1): 118-120.(in Chinese)
[20] 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, 2021, 28(1): 30-34.
Liu ZW, Xu XL, Zeng YJ, et al. Comparison of diagnostic efficacy of two nutritional risk screening tools in children with congenital heart disease[J]. Parenteral and Enteral Nutrition, 2021, 28(1): 30-34.(in Chinese)
[21] 付晓莹, 赵青, 刘晓莉, 等. 2种营养风险筛查工具对儿童消化系统疾病住院患儿的应用评价[J]. 现代消化及介入诊疗, 2023, 28(2): 248-254.
Fu XY, Zhao Q, Liu XL, et al. Application evaluation of two nutritional risk screening tools in hospitalized children with digestive system diseases[J]. Modern Digestive and Interventional Medicine, 2023, 28(2): 248-254.(in Chinese)
[22] 张晓燕, 吴斌. 不同营养风险筛查方法在住院新生儿中的应用比较[J]. 吉林医学, 2022, 43(6): 1703-1706.
Zhang XY, Wu B. Comparison of different nutritional risk screening methods in hospitalized neonates[J]. Jilin Medicine, 2022, 43(6): 1703-1706.(in Chinese)
[23] Huysentruyt K, Alliet P, Muyshont L, et al. The STRONG(kids) nutritional screening tool in hospitalized children:A validation study[J]. Nutrition, 2013, 29(11-12): 1356-1361.
[24] 邹沙芹, 段伟莉, 周桂芬, 等. 两种改良营养风险筛查表在普外科住院患儿的应用研究[J]. 当代护士(下旬刊), 2021, 28(10): 6-9.
Zou XQ, Duan WL, Zhou GF, et al. Application of two modified nutritional risk screening tables in hospitalized children in general surgery Department[J]. Contemporary Nurses(The next ten-day Periodical), 2021, 28(10): 6-9.(in Chinese)
[25] Wonoputri N, Djais JT, Rosalina I. Validity of nutritional screening tools for hospitalized children[J]. J Nutr Metab, 2014, 2014: 143649.
[26] McCarthy H, Dixon M, Crabtree I, et al. The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics(STAMP(c)) for use by healthcare staff[J]. J Hum Nutr Diet, 2012, 25(4): 311-318.
[27] Barros TA, Cruvel J, Silva BM, et al. Agreement between nutritional risk screening tools and anthropometry in hospitalized pediatric patients[J]. Clin Nutr ESPEN, 2022, 47: 227-232.
[28] Osorio-Alamillo Y, Fuentes-Cummings J, Ruiz-Barranco A, et al.Adaptation in Spanish and validation in Mexico of the Screening Tool for the Assessment of Malnutrition in Paediatrics(STAMP)[J]. Nutr Hosp, 2023, 40(2): 354-361.
[29] 黎丽, 冯梅, 周丹, 等. 基于健康信息系统的STAMP在重症先天性心脏病患儿中的预测价值研究[J]. 中国胸心血管外科临床杂志, 2021, 28(11): 1340-1345.
Li L, Feng M, Zhou D, et al. Predictive value of STAMP in children with severe congenital heart disease based on health information system[J]. Chin J Cardiothoracic Surgery, 2021, 28(11): 1340-1345.(in Chinese)
[30] Reed M, Mullaney K, Ruhmann C, et al. Screening Tool for the Assessment of Malnutrition in Pediatrics(STAMP) in the electronic health record: A validation study[J]. Nutr Clin Pract, 2020, 35(6): 1087-1093.
[31] Gerasimidis K, Macleod I, Maclean A, et al. Performance of the novel Paediatric Yorkhill Malnutrition Score(PYMS) in hospital practice[J]. Clin Nutr, 2011, 30(4): 430-435.
[32] Katsagoni CN, Cheirakaki O, Hatzoglou A, et al. Malnutrition in hospitalised children-An evaluation of the efficacy of two nutritional screening tools[J]. Nutrients, 2021, 13(4):1279.
[33] Seremet Kurklu N, Geyin F, Ceylan L, et al. Comparison of three different nutrition screening tools for pediatric inpatients[J]. Nutr Clin Pract, 2022, 37(3): 698-704.
[34] 李凌燕, 林莹, 苟芸, 等. STRONGkids、PYMS与STAMP在烧伤住院患儿营养风险筛查中的比较研究[J]. 营养学报, 2022, 44(4): 377-383.
Li LY, Lin Y, Gou Y, et al. Comparative study of STRONGkids, PYMS and STAMP in nutritional risk screening of hospitalized children with burns[J]. Chinese Journal of Nutrition, 2022, 44(4): 377-383.(in Chinese)
[35] Lara-Pompa N E, Hill S, Williams J, et al. Use of standardized body composition measurements and malnutrition screening tools to detect malnutrition risk and predict clinical outcomes in children with chronic conditions[J]. Am J Clin Nutr, 2020, 112(6): 1456-1467.
[36] Pars H, Acikgoz A, Erdogan B D. Validity and reliability of the Turkish version of three screening tools(PYMS, STAMP, and STRONG-kids) in hospitalized children[J]. Clin Nutr ESPEN, 2020, 39: 96-103.
[37] Klanjsek P, Pajnkihar M, Marcun Varda N, et al. Screening and assessment tools for early detection of malnutrition in hospitalised children:A systematic review of validation studies[J]. BMJ Open, 2019, 9(5): e025444.
[38] 乔俊英, 郭菲菲, 李凡, 等. 危重患儿营养评估及营养风险筛查工具的临床应用[J]. 中国当代儿科杂志, 2019, 21(6): 528-533.
Qiao JY, Guo FF, Li F, et al. Clinical application of nutritional assessment and nutritional risk screening tools in critically ill children[J]. Chin J Contemporary Pediatrics, 2019, 21(6): 528-533.(in Chinese)
[39] White M, Lawson K, Ramsey R, et al. Simple nutrition screening tool for pediatric inpatients[J]. JPEN J Parenter Enteral Nutr, 2016, 40(3): 392-398.
[40] Ong SH, Chen ST. Validation of Paediatric Nutrition Screening Tool(PNST) among hospitalized Malaysian children[J]. J Trop Pediatr, 2020, 66(5): 461-469.
[41] Carter LE, Shoyele G, Southon S, et al. Screening for pediatric malnutrition at hospital admission: Which screening tool is best?[J]. Nutr Clin Pract, 2020, 35(5): 951-958.
[42] Murphy AJ, White M, Viani K, et al. Evaluation of the nutrition screening tool for childhood cancer(SCAN)[J]. Clin Nutr, 2016, 35(1): 219-224.
[43] Canedo G, Palomino Perez LM, Puerta MacfarlandLA, et al. Validity and Reliability of a Nutritional Screening Tool(SCAN) in Children Newly Diagnosed with Cancer[J]. Nutr Cancer, 2022, 74(5): 1754-1765.
[44] Lu L, Mao X, Sheng J, et al. Development and validation of a pediatric nutritional screening score(PNSS) for hospitalized children[J]. Asia Pac J Clin Nutr, 2018, 27(1): 65-71.
[45] 盛金叶, 茅晓蒙, 陆丽娜,等. 住院儿童应用改良儿科营养不良风险筛查工具的临床评价[J]. 中国实用儿科杂志, 2018, 33(4): 281-285.
Sheng JY, Mao XM, Lu LN, et al. Clinical evaluation of the use of improved pediatric malnutrition risk screening tools in hospitalized children[J] Chin J Prac Pediatr, 2018, 33(4): 281-285.(in Chinese)
[46] 李心仪, 黄晟, 周洪敏, 等. 改良儿科营养风险筛查工具的临床应用[J]. 中国当代儿科杂志, 2021, 23(2): 186-191.
Li XY, Huang S, Zhou HM, et al. Clinical application of modified pediatric nutritional risk screening tool[J]. Chin J Contemporary Pediatrics, 2021, 23(2): 186-191.(in Chinese)
[47] 吴莉娟. STRONGkids和PNSS营养风险筛查工具在儿科消化住院患者的临床应用[D]. 重庆: 重庆医科大学, 2021.
Wu LJ. Clinical application of STRONGkids and PNSS nutritional risk screening tools in pediatric inpatients with digestive diseases[D]. Chongqing: Chongqing Medical University, 2021.(in Chinese)
[48] 陈慧敏, 刘喜红, 孙静, 等. 402例住院患儿的营养风险筛查[J]. 广州医药, 2015, 46(1): 46-48.
Chen HM, Liu XH, Sun J, et al. Nutritional risk screening in 402 hospitalized children[J]. Guangzhou Medicine, 2015, 46(1): 46-48.(in Chinese)
[49] 刘汉友, 朱登纳, 陈功勋, 等. 主观全面营养评估量表在脑性瘫痪住院患儿中的临床有效性验证[J]. 中国当代儿科杂志, 2020, 22(11): 1188-1192.
Liu HY, Zhu DN, Chen GX, et al. Clinical validation of subjective global assessment scale in hospitalized children with cerebral palsy[J]. Chin J Contemporary Pediatrics, 2020, 22(11): 1188-1192.(in Chinese)
[50] 王柯, 周明明, 宋杰, 等. 改良儿科营养风险筛查工具的筛检效果评价及临床结局相关性分析[J]. 现代预防医学, 2023, 50(6): 1053-1057.
Wang K, Zhou MM, Song J, et al. Screening effect evaluation and clinical outcome correlation analysis of modified pediatric nutritional risk screening tool[J]. Modern Preventive Medicine, 2023, 50(6): 1053-1057.(in Chinese)
[51] White MS, Ziemann M, Doolan A, et al. A simple nutrition screening tool to identify nutritional deterioration in long stay paediatric inpatients: The paediatric nutrition rescreening tool(PNRT)[J]. Clin Nutr ESPEN, 2019, 34: 55-60.
[52] Lameu EB, Gerude MF, Campos AC, et al. The thickness of the adductor pollicis muscle reflects the muscle compartment and may be used as a new anthropometric parameter for nutritional assessment[J]. Curr Opin Clin Nutr Metab Care, 2004, 7(3): 293-301.
[53] de Oliveira CM, Kubrusly M, Mota RS, et al. Adductor pollicis muscle thickness: A promising anthropometric parameter for patients with chronic renal failure[J]. J Ren Nutr, 2012, 22(3): 307-316.
[54] Yoshimura da Costa T, Yukari Suganuma J, Faria S, et al. Association of adductor pollicis muscle thickness and handgrip strength with nutritional status in hospitalized individuals[J]. Nutr Hosp, 2021, 38(3): 519-524.
[55] Duarte RRP, Gonzalez MC, Oliveira JF, et al. Is there an association between the nutritional and functional parameters and congestive heart failure severity?[J]. Clin Nutr, 2021, 40(5): 3354-3359.
[56] 马晓叶, 方秀新, 吕小芹, 等. 拇内收肌厚度测量在消化系统恶性肿瘤患者营养评估中的应用价值[J]. 护理学杂志, 2018, 33(11): 12-15.
Ma XY, Fang XX, Lyu XQ, et al. Application value of adductor pollicis muscle thickness measurement in nutritional assessment of patients with digestive system malignant tumors[J]. Chinese Journal of Nursing, 2018, 33(11): 12-15.(in Chinese)
[57] Dos Santos Rd CO, Burgel CF, Chites Rd VS, et al. Low-cost and fast-performing indicators of muscle mass loss are good predictors of clinical outcomes in hospitalized patients: A longitudinal observational study[J]. JPEN J Parenter Enteral Nutr, 2022, 46(4): 887-895.
[58] Vallandro JP, da Silveira Klein Campos L, Neumann LD, et al. Adductor muscle thickness of the thumb: A new and reliable parameter for nutritional assessment of pediatric inpatients[J]. Clin Nutr, 2019, 38(2): 891-896.
[59] 王丽. 两种营养风险筛查工具在住院患儿营养评估中的应用价值评价[D].福州:福建医科大学,2020.
Wang L. Evaluation of two nutritional risk screening tools in nutritional assessment of hospitalized children[D].Fuzhou:Fujian Medical University, 2020.(in Chinese)
[60] Gerasimidis K, Milani S, Tester A, et al. A multicentre development and evaluation of a dietetic referral score for nutritional risk in sick infants[J]. Clin Nutr, 2019, 38(4): 1636-1642.
[61] 李语薇, 尹华英, 张先红. 尚待临床有效性验证的新生儿营养风险筛查工具[J]. 中华临床营养杂志, 2017, 25(2): 111-117.
Li YW, Yin HY, Zhang XH. Neonatal nutritional risk screening tools need to be clinically validated[J]. Chinese Journal of Clinical Nutrition, 2017, 25(2): 111-117.(in Chinese)
[62] 白铂亮, 张岚, 高琼, 等. 多维度新生儿营养风险筛查量表在新生儿病房住院患儿中的应用[J]. 中国儿童保健杂志, 2019, 27(10): 1109-1111.
Bai BL, Zhang L, Gao Q, et al. Application of multi-dimensional neonatal nutritional risk screening scale in hospitalized children in neonatal ward[J]. Chin J Child Health Care, 2019, 27(10): 1109-1111.(in Chinese)
[63] Johnson M J, Pearson F, Emm A, et al. Developing a new screening tool for nutritional risk in neonatal intensive care[J]. Acta Paediatr, 2015, 104(2): e90-e93.