目的 对肥胖门诊儿童青少年肥胖干预效果进行评价,以了解干预效果及影响因素。方法 1995-2011年肥胖门诊就诊肥胖患儿1 045人,选取随访时间持续1个月以上的115人,评价肥胖干预效果及其影响因素。结果 初诊肥胖患儿1 045人(男712人,女333人),随访时间持续1个月以上115人(男74人,女41人),低年龄组(≤11岁)及高年龄组(>11岁)经门诊干预1~3个月、4~6个月及6个月以上干预后,肥胖度分别降低8.8%和7.8%、18.8%和16.5%、27.4%和25.2%。两个年龄组在肥胖门诊干预4~6个月和6个月以上显效率(87.2%和87.5%)明显高于1~3个月(51.6%)((χ2=26.29,P<0.01))。初诊肥胖度及随访持续时间与肥胖度改善正相关(r分别为0.35和0.53,P＜0.01),初诊年龄与肥胖度变化负相关(r=-0.24,P＜0.05)。 结论 通过肥胖门诊对肥胖患儿进行相关健康指导有助于儿童肥胖的预防和控制,但目前肥胖门诊患儿的依从性还不是很乐观。
Abstract
Objective To evaluate the outcome of the childhood obesity management in the obesity clinic. Method During 1995 and 2011,there were 1 045 obese children and adolescents (boys 712,girls 333)visited the obesity clinic.The outcome of intervention and the possible influencing factors were evaluated of the 115 patients who followe-up for more than one month. Results The number of patients who treated more than one month were 115.After 1~3 months,4~6 months and more than 6 months follow-up intervention respectively,the degrees of obesity of the low age group (≤11 yrs) and high age group (＞11 yrs) outpatients were decreased by 8.8% and 7.8%,18.8% and 16.5%,27.4% and 25.2% respectively (P<0.05).Outcome of outpatients who adhered to the follow-up for 4~6 months and more than 6 months showed significant efficiency (87.2% and 87.5% respectively) than the 1~3 months group (51.6%)(χ2 = 26.29,P<0.01).The change of the obesity degree was positively correlated with the initial obesity degree and follow-up time(r= 0.35 and 0.53,respectively,P<0.01).In addition a negative correlation was found between initial age and the change of obesity degree (r=-0.24,P<0.05). Conclusion It is very effective to treat the obesity children at the outpatient clinic.But the compliance of the patients was not optimistic.
关键词
肥胖 /
门诊 /
干预 /
儿童
Key words
obesity /
outpatient /
intervention /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 李珊珊,王海俊,马军.儿童肥胖的流行趋势[J].中国生育健康杂志,2008,19(3):173-175.
[2] Biro FM,Wien M.Childhood obesity and adult morbidities[J].Am J Clin Nutr,2010,91(5S):1499-1505.
[3] Ekelund U,Anderssen S,Andersen LB,et al.Prevalence and correlates of the metabolic syndrome in a population-based sample of European youth[J].Am J Clin Nutr,2009,89(1):90-96.
[4] Tim JC,Mary CB,Kancherine MF,et al.Establishing a standerd definition for child overweight and obesity worldwide international suevey[J].BMJ,2000,320:1-6.
[5] 胡亚美,江载芳.儿童期单纯肥胖症诸福棠实用儿科学[M].7版.北京:人民卫生出版社,2002:552-557.
[6] 万燕萍.患了儿童肥胖病怎么办[M].上海:上海科学技术文献出版社,2001:30-35.
[7] 《中华儿科杂志》编辑委员会.儿童青少年血脂异常防治专家共识[J].中华儿科杂志,2009,60(6):426-428.
[8] De Piano A,Prado WL.Metabolic and nutritional profile of obese adolescents with nonalcoholic fatty liver disease[J].J Pediatr Gastroenterol Nutr,2007,44(4):446-452.
[9] Denzer C,Reithofer E,Wabitsch M,et al.The outcome of childhood obesitymanagement depends highly upon patient compliance[J].Eur J Pediatr,2004,163(2):99-104.
[10] Patrick H,Nicklas TA.A review of family and social determinants of children's eating patterns and diet quality[J].J Am Coll Nutr,2005,24:83-92.
[11] Pearson N,Biddle SJ.Family correlates of fruit and vege table consumption in children and adolescents:A systematic review[J].Public Health Nutr,2009,12:267-283.
[12] Hollie AR.The Relationship between child and parent food hedonics and parent and child food group intake in children with overweight/obesity[J].J Am Diet Assoc,2011,111:425-430.
[13] O'Brien SH,Holubkov R.Identification,evaluation,and management of obesity in an academic primary care center[J].Pediatrics,2004,114(2):e154-159.
[14] Yücel O,Kinik ST.Diagnosis of a trend towards obesity in preschool children:a longitudinal study[J].Eur J Pediatr,2011,170(6):751-756.
基金
上海市公共卫生体系建设三年行动计划(2011-2013);上海市科学技术委员会科研计划项目(11DZ2260500)
PDF(525 KB)
