广州市福利机构学龄脑性瘫痪儿童营养状况及相关因素分析

陈静仪; 肖嘉琪; 郭峰; 梁荃佺; 杨杰文

doi:10.16835/j.cnki.1000-9817.2024283

广州市福利机构学龄脑性瘫痪儿童营养状况及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2024283

广州市社会福利院, 广东 510000

基金项目:

广州市“岭南英杰工作”第二梯队后备人才项目穗人社函[2019]928号

2022年度广州市民政科技基金课题揭榜挂帅技术攻关项目 2022MZK02

详细信息

作者简介:
陈静仪(1980-)，女，广东南海人，大学本科，副主任医师，主要研究方向为儿少卫生、传染病防控

通讯作者:
杨杰文, E-mail: 360449586@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R651.1⁺⁵ R748 R153.2
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出版历程
- 收稿日期: 2024-05-17
- 修回日期: 2024-08-20
- 网络出版日期: 2024-10-08
- 刊出日期: 2024-09-25

Analysis of nutritional status and related factors of school-aged children with cerebral palsy in a welfare institution of Guangzhou

Guangzhou Social Welfare Institute, Guangzhou (510000), Guangdong Province, China

摘要

摘要: 目的探讨学龄脑性瘫痪(简称“脑瘫”)儿童营养不良发生状况及相关因素分析，为相关机构制定有针对性的政策提供参考依据。方法 2023年7—8月，采用整群抽样方法抽取广州市市级福利机构内333名6~18岁学龄脑瘫儿童和960名其他疾病儿童为研究对象，测量身高和体重并分析其营养状况。采用多因素Logistic回归分析学龄脑瘫儿童营养不良的相关因素。结果广州市福利机构学龄脑瘫儿童生长迟缓占比为74.5%，消瘦为17.7%，营养正常为7.2%，超重或肥胖为0.6%；单因素分析结果显示，不同性别、粗大运动功能分级系统(GMFCS)分级、是否存在吞咽障碍学龄脑瘫儿童营养不良的检出率差异均有统计学意义(χ²值分别为6.02，15.23，32.16，P值均＜0.05)。多因素Logistic回归分析结果显示，性别(OR=0.37, 95%CI=0.15~0.91)、吞咽障碍(OR=4.10, 95%CI=1.39~12.12)、GMFCS分级(OR=1.45, 95%CI=1.04~3.01)均是学龄脑瘫儿童营养不良的影响因素(P值均 < 0.05)。结论广州市福利机构学龄脑瘫儿童营养不良检出率较高，受多种因素影响。应根据学龄脑瘫儿童营养不良的风险因素，制定并实施相应的营养干预措施，以改善其营养状况。
- 儿童福利 /
- 慈善机构 /
- 脑性瘫痪 /
- 营养状况 /
- 回归分析 /
- 儿童
Abstract: Objective To under the prevalence of malnutrition and its associated factors in school-aged children with cerebral palsy, so as to provide a basis for relevant departments to formulate targeted policies. Methods From July to August 2023, the researchers selected 333 children with cerebral palsy and 960 children with other diseases aged 6-18 years who were residents of a social welfare institution in Guangzhou, China. Their height and weight were measured and a nutritional status analysis was carried out using a cluster sampling method. Multivariate Logistic analysis was performed to analyze the relative factors and malnutrition status of school-aged children with cerebral palsy. Results The prevalence of growth retardation among school-aged children with cerebral palsy was 74.5%, with rates of stunting, normal nutrition status, and overweight/obesity being 17.7%, 7.2%, and 0.6%, respectively. The results of the univariate analysis revealed statistically significant differences in the detection rate of malnutrition among school-aged children with cerebral palsy based on gender, gross motor function classification system (GMFCS) grading, and the presence of swallowing disorders (χ²=6.02, 15.23, 32.16, P < 0.05). The results of the multivariate Logistic regression analysis showed that gender (OR=0.37, 95%CI=0.15-0.91), dysphagia (OR=4.10, 95%CI=1.39-12.12), and GMFCS classification (OR=1.45, 95%CI=1.04-3.01) were influencing factors of malnutrition (P < 0.05). Conclusions The detection rate of malnutrition among children and adolescents with cerebral palsy in welfare institutions was found to be relatively high, and influenced by various factors. Corresponding nutritional interventions should be developed and implemented based on the risk factors of malnutrition in school-aged children with cerebral palsy to improve their nutritional status.
- Child welfare /
- Charities /
- Cerebral palsy /
- Nutritional status /
- Regression analysis /
- Child
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表 1 广州市福利机构不同年龄脑瘫儿童营养状况分布

Table 1. Distribution of nutritional status of children with cerebral palsy in different ages in a welfare institution of Guangzhou

年龄/岁	人数	生长迟缓	消瘦	营养正常	超重或肥胖
6	2	0	2(100.0)	0	0
7	12	8(66.7)	3(25.0)	1(8.3)	0
8	10	4(40.0)	5(50.0)	1(10.0)	0
9	24	19(79.2)	5(20.8)	0	0
10	39	33(84.6)	5(12.8)	1(2.6)	0
11	35	24(68.6)	7(20.0)	3(8.6)	1(2.8)
12	48	36(75.0)	9(18.7)	3(6.3)	0
13	40	31(77.5)	7(17.5)	2(5.0)	0
14	33	24(72.7)	4(12.1)	5(15.2)	0
15	34	29(85.3)	4(11.8)	0	1(2.9)
16	21	15(71.4)	2(9.5)	4(19.1)	0
17	19	14(73.7)	2(10.5)	3(15.8)	0
18	16	11(68.7)	4(25.0)	1(6.3)	0
合计	333	248(74.5)	59(17.7)	24(7.2)	2(0.6)
注： ()内数字为构成比/%。

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表 2 广州市福利机构不同疾病种类学龄儿童营养状况比较

Table 2. Comparison of nutritional status among school-age children with different types of diseases in a welfare institution of Guangzhou

组别	人数	生长迟缓	消瘦	超重或肥胖
脑瘫儿童	333	248(74.5)	59(17.7)	2(0.6)
智力发育迟缓	57	2(3.5)	11(19.3)	2(3.5)
精神发育迟滞	558	93(16.7)	223(40.0)	41(7.3)
先天性疾病	140	61(43.6)	10(7.1)	22(15.7)
多系统疾病^*	205	97(47.3)	40(19.5)	8(3.9)
合计	1 293	501(38.7)	343(26.5)	75(5.8)
χ²值		331.3	98.6	46.0
P值		＜0.01	＜0.01	＜0.01
注：()内数字为检出率/%；^*指≥2个系统疾病。

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表 3 广州市福利机构学龄脑瘫儿童营养不良单因素分析

Table 3. Single-factor analysis of malnutrition in school-age children with cerebral palsy in welfare institutions of Guangzhou

组别	选项	人数	营养不良人数	χ²值	P值
性别	男	204	193(94.6)	6.02	0.01
	女	129	114(88.4)
入院时长/年	0~2	15	14(93.3)	0.29	0.97
	3~10	183	169(92.3)
	11~15	123	113(91.9)
	>15	12	11(91.7)
吞咽障碍	是	195	189(96.9)	15.23	＜0.01
	否	138	118(85.5)
脑瘫类型	痉挛型四肢瘫	195	173(88.7)	2.38	0.79
	痉挛型双肢瘫	66	60(90.9)
	痉挛型偏瘫	14	12(85.7)
	不随意运动型	27	26(96.3)
	共济失调	7	6(85.7)
	混合型	24	22(91.7)
GMFCS分级	Ⅰ级	8	8(100.0)	32.16	＜0.01
	Ⅱ级	27	20(74.1)
	Ⅲ级	19	15(78.9)
	Ⅳ级	42	34(81.0)
	Ⅴ级	237	230(97.0)
注：()内数字为检出率/%。

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