胎儿营养不良评估方案的研究

doi:10.7499/j.issn.1008-8830.2007122

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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。

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	林晓雨
	刘建兵
	杜秀萍
	关涵州
	张卫兵
	李文龙
	徐祥波
	李莉
	刘铭

关键词 ：胎儿营养不良, 人体测量学法, 临床营养评估法, 新生儿

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.

Key words： Fetal malnutrition Anthropometrics Clinical Assessment of Nutritional Status Neonate

收稿日期: 2020-07-16

基金资助:比尔盖茨·梅琳达基金子课题（2F022016015）。

通讯作者: 刘铭,女,副教授。Email:lium@sxmu.edu.cn。 E-mail: lium@sxmu.edu.cn

作者简介: 林晓雨,男,硕士研究生,住院医师。

引用本文:

林晓雨,刘建兵,杜秀萍等. 胎儿营养不良评估方案的研究[J]. 中国当代儿科杂志, 2020, 22(12): 1273-1278.

LIN Xiao-Yu,LIU Jian-Bing,DU Xiu-Ping et al. Fetal malnutrition assessment program[J]. CJCP, 2020, 22(12): 1273-1278.

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http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2007122 或 http://www.zgddek.com/CN/Y2020/V22/I12/1273

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