Objective: To explore the reasonable and effective enteral nutrition regimen for children with abdominal Henoch-Schönlein purpura (HSP).
Methods: A retrospective analysis was performed on the medical data of children with abdominal HSP who were hospitalized from August 2013 to August 2018. According to the starting time of enteral nutrition after abdominal pain relief, the children were divided into three groups: < 24 hours (n=68), 24-48 hours (n=64), and 48-72 hours (n=60). According to the type of enteral nutrition, they were divided into another three groups:amino acid-based formula (n=53), extensively hydrolyzed lactoprotein formula (n=67), and normal diet (n=72). The recurrence rate of clinical symptoms and degree of satisfaction among family members were compared between groups. Based on the retrospective analysis, 166 children with abdominal HSP were enrolled in a prospective study. They were given extensively hydrolyzed lactoprotein formula after abdominal pain relief. According to the feeding time after abdominal pain relief, they were divided into three groups: < 24 hours (n=52), 24-48 hours (n=59), and 48-72 hours (n=55). The three groups were compared in terms of the recurrence rates of abdominal pain, rash, and hematochezia, the rate of use of parenteral nutrition and intravenous steroids, and the incidence rate of weight loss at discharge.
Results: The retrospective analysis showed that the children who were given extensively hydrolyzed lactoprotein formula for enteral nutrition at 24-48 hours after abdominal pain relief had a lower recurrence rate of clinical symptoms and the highest degree of satisfaction among their family members (P < 0.0167). The prospective study showed that the children who were given extensively hydrolyzed lactoprotein formula for enteral nutrition at 24-48 hours after abdominal pain relief had lower recurrence rates of rash and abdominal pain, a lower rate of use of parenteral nutrition, and a lower incidence rate of weight loss at discharge (P < 0.05).
Conclusions: It is reasonable and effective to start the feeding with extensively hydrolyzed lactoprotein formula at 24-48 hours after abdominal pain relief in children with abdominal HSP.
目的: 探讨腹型过敏性紫癜患儿合理有效的肠内营养方案。
方法: 回顾性分析我院2013年8月至2018年8月间腹型过敏性紫癜住院患儿的临床资料；根据腹痛缓解后开始肠内营养时间不同分为 < 24 h组（n=68）、24 h~组（n=64）、48~72 h组（n=60），根据引入肠内营养种类不同分为氨基酸配方组（n=53）、乳蛋白深度水解配方组（n=67）和普通食物组（n=72）；比较不同组别患儿临床症状反复发生率及家属满意度。在回顾性研究基础上，招募了166例腹型过敏性紫癜患儿进行前瞻性研究；所有患儿在腹痛缓解后均采用乳蛋白深度水解配方奶喂养，根据腹痛缓解后喂养时间不同分为 < 24 h组（n=52）、24 h~组（n=59）、48~72 h组（n=55）；比较三组患儿腹痛、皮疹、便血症状反复发生率及静脉营养使用率、静脉激素使用率、出院时体重降低发生率。
结果: 回顾性研究结果显示，腹痛缓解后24~ < 48 h开始肠内营养及引入乳蛋白深度水解配方奶行肠内营养，患儿不仅临床症状反复发生率低，且其家属满意度最高（P < 0.0167）。前瞻性研究结果显示，腹痛缓解后24~ < 48 h开始引入乳蛋白深度水解配方奶行肠内营养患儿皮疹、腹痛反复发生率低，静脉营养使用率及患儿出院时体重下降发生率低（P < 0.05）。
结论: 腹型过敏性紫癜患儿在腹痛缓解后24~ < 48 h引入乳蛋白深度水解配方奶喂养是合理有效的，值得临床广泛应用。