胎儿营养不良评估方案的研究

Fetal malnutrition assessment program

摘要:

目的 比较重量指数（PI）、体重指数（BMI）、中段上臂围/头围（MAC/HC）及临床营养评估法（CANS）在新生儿出生时营养状况评估中的应用，以寻求一种简便而可靠的评估胎儿营养状况的方案。方法 利用PI、BMI、MAC/HC及CANS法对刚出生的足月儿和早产儿进行营养状态评估，并对各种方法的评估结果进行分析。结果 在678名足月儿中，PI、BMI、MAC/HC及CANS法分别诊断61例、102例、47例、131例营养不良。在140名早产儿中，PI、BMI、MAC/HC及CANS法分别诊断30例、87例、9例、112例营养不良。BMI+CANS组合检出比例在足月儿和早产儿中分别为99.3%、100%，与1种方法相比，能够显著提高营养不良患者的检出率（P < 0.05），而与PI+BMI+CANS 3种方法组合相比，差异无统计学意义（P > 0.05）。结论 BMI+CANS组合能减少胎儿营养不良的漏诊，是评估胎儿营养不良简便而可靠的方法。

Abstract:

Objective To study the application of ponderal index (PI), body mass index (BMI), mid-arm circumference/head circumference (MAC/HC), and Clinical Assessment of Nutritional Status (CANS) score in assessing the nutritional status of neonates at birth, and to find a simple and reliable scheme for the assessment of fetal nutritional status. Methods PI, BMI, MAC/HC, and CANS were used to assess the nutritional status of full-term infants and preterm infants shortly after birth. The assessment results of these methods were analyzed. Results Among the 678 full-term infants, 61, 102, 47, and 131 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. Among the 140 preterm infants, 30, 87, 9, and 112 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. The combination of BMI and CANS had a detection rate of 99.3% in full-term infants and 100% in preterm infants. Compared with the single method, the combination significantly improved the detection rate of malnutrition (P < 0.05), while there was no significant difference between the combination of BMI+CANS and the combination of PI+BMI+CANS (P > 0.05). Conclusions The combination of BMI+CANS can reduce the rate of missed diagnosis of fetal malnutrition. It is therefore a simple and reliable method for the assessment of fetal malnutrition.