先天性心臟病童使用營養補充品之現況

Dietary supplements in children with congenital heart disease

陳燕慈(Yen-Tsz Chen)

指導教授 ： 趙振瑞

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2005年)

摘要

本研究探討先天性心臟病童主要照顧者給與病童食用營養補充 品的現況、影響因素及其自覺效果，作為日後實施營養教育介入之參考，以改善病童的營養和生長狀況。本研究以台北市某醫學中心，住院作心導管檢查或治療，6個月大至6歲以下之先天性心臟病童及其主要照顧者為對象。以問卷訪問44位病童主要照顧者，並利用病童心導管檢查後剩餘的血液檢體，作血清鐵、血清鐵蛋白、運鐵容量和運鐵蛋白飽和度等分析，採24小時飲食回憶法和出院後三天的飲食紀錄，作病童之飲食評估。結果顯示：依據心臟損傷類型之發紺和非發紺型來看，兩組在性別、年齡、體重、身高和長期營養狀況上，皆無統計上的差異。而以病童是否併發心臟衰竭所作長期營養狀況之比較，也無統計上差異。部分1-3.9歲病童飲食攝取狀況，併發心臟衰竭的病童熱量攝取明顯少於未併發心臟衰竭的病童。先天性心臟病童的營養狀況，並未因併發心臟衰竭而較差，但部份病童在熱量攝取方面的確明顯較少。病童食用營養補充品之情形，54.5%按時服用，36.4%偶而服用，僅9.1%是從未服用過。依組別之病童服用比率，發紺型(100.0%)略高於非發紺型(88.2%)。服用種類幾乎達三分之二是「營養強化配方」，超過三分之一是「乳酸菌」、「綜合維生素和礦物質」和「礦物質」。服用原因主要是補充營養和增加免疫力。病童食用營養補充品後，主要照顧者自覺有效果，在發紺型組(70.0%)略高於非發紺型組(53.3%)。效果以「增加免疫力」為最多。僅有1位發紺型病童發現有鐵貯存耗盡的問題，而在非發紺型病童中並未發現。病童平均熱量攝取是國人膳食營養素參考攝取量之82.5%-92.9%，蛋白質平均攝取量為建議量之1.2-1.7倍。

關鍵字

先天性心臟病 ； 營養補充品

並列摘要

This study investigated dietary supplements of the children with congenital heart disease (CHD) from the main caring persons, as well as influence factors and conscientious effects of using dietary supplements for the intervation of nutritional education and the enhancement of nutritional and growth status in the patients. The subjects were recruited from the pediatric in-patients with 6-month to 6-year-old for the examination or therapy of cardiac catheter at the medical center in Taipei. Fort-four main caring persons for the subjects were screened by the questionnaire. The blood samples of the subjects were analyzed for serum iron, ferritin, total iron-binding capacity, and total iron-binding capacity saturation after cardiac catheter therapy. The 24-hour dietary recall and 3-day dietary records were collected for the dietary assessment. The results showed that sex, age, body weight, height, and long-term nutritional status were not significantly different between cyanotic and noncyanotic CHD groups. Long-term nutritional status was not different between the children with and without heart failure as well. Caloric intake in the 1-to-3.9 year-old children with heart failure was obviously lower than that in the children without heart failure. The nutritional status in the children with CHD was not poor due to heart failure. However, caloric intake was less in some of the children with CHD. Regarding dietary supplements in the children with CHD, 54.5% children regularly consumed, 36.4% occasionally consumed, and only 9.1% never consumed dietary supplements among 44 subjects. The frequency for using dietary supplements in the children with cyanotic CHD was slightly higher compared with those with noncyanotic CHD (100.0% versus 88.2%). Among dietary supplements, nearly two third were nutrient-fortified formula, and over one third were lactobacteria, multivitamins and minerals, as well as minerals. The main reason for consuming dietary supplements was to supply nutrients and enhance immunity. The percentage of the main caring persons who consciously feel the effectiveness of dietary supplements was slightly higher in the children with cyanotic CHD compared with those with noncyanotic CHD (70.0% versus 53.3%). The most effectiveness of dietary supplements was to enhance immunity. Only one subject with cyanotic CHD had iron-depleting problem, whereas none was observed in the children with noncyanotic CHD. The mean caloric and protein intake of the subjects was 82.5% to 92.9% and 1.2- to 1.7-fold of the Dietary Reference Intakes, respectively.

並列關鍵字

congenital heart disease ； dietary supplement

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