摘要目的 探讨婴幼儿下呼吸道感染营养风险发生率,比较不同营养风险对其临床结局的影响,为婴幼儿下呼吸道感染临床营养管理提供依据.方法 选取2013年1月至2016年3月在本院儿内科住院治疗的下呼吸道感染婴幼儿为研究对象.采用营养状况和生长风险筛查工具(STRONGkids)进行筛查.结果 957例婴幼儿下呼吸道感染纳入研究,高营养风险、 中低营养风险发生率分别为17.6％、82.4％,其临床治愈率分别为68.5％、71.4％;肺炎和支气管炎患儿高营养风险发生率分别为20.60％、4.87％,差异有统计学意义(χ2=25.52,P=0.000).时间-效应单因素分析(Kaplan-Meier法):婴幼儿中低营养风险和高营养风险的住院时间分别为9.3(0.3)d、13.3(1.0)d,两组间比较差异均有统计学意义(χ2=28.33,P=0.000),住院总费用分别为5653.5(224.8)元、10079.5(1755.8)元,两组间比较差异有统计学意义(χ2=4.47,P=0.034).多因素COX回归分析:高营养风险是住院婴幼儿下呼吸道感染住院时间的危险因素(RR=1.57,P=0.024).结论 婴幼儿下呼吸道感染存在较高的高营养风险发生率,与中低营养风险患儿比较,高营养风险患儿住院时间延长、 住院费用增加、 临床治愈率降低,是影响临床结局的危险性因素.因此,有必要对婴幼儿下呼吸道感染患儿实行营养风险筛查,为进行临床营养评价及营养干预提供理论依据.

abstractsObjective To investigate the incidence of nutritional risk in infants with lower respiratory tract infection, and to compare the effects of different nutritional risks on clinical outcomes, and to provide evi-dence for clinical nutritional management of infantile lower respiratory tract infection. Methods Infants and young children with lower respiratory tract infection who were hospitalized in our hospital from January 2013 to March 2016 were selected as subjects. Nutritional risk screening was performed using the Nutritional Status and Growth Risk Screening Tool ( STRONGkids) . Results A total of 957 infants with lower respiratory tract infec-tions were included in the study. The incidence of high nutrition risk and low and medium nutritional risk were 17. 6％ and 82. 4％, respectively. The clinical cure rate was 68. 5％ and 71. 4％ respectively. The children with pneumonia and bronchitis had high nutritional risk. The incidence rates were 20. 60％ and 4. 87％, respectively, and the difference was statistically significant (χ2=25. 52, P=0. 000) . Time-effect single factor analysis ( Kaplan-Meier method):The hospitalization time for infants with low nutritional risk and high nutri-tional risk was 9. 3 ( 0. 3) d and 13. 3 ( 1. 0) d, respectively. The difference between the two groups was sta-tistically significant. (χ2=28. 33, P=0. 000) , the total hospitalization expenses were 5653. 5 ( 224. 8) yuan and 10079. 5 ( 1755. 8) yuan respectively. The difference between the two groups was statistically significant (χ2=4. 47, P=0. 034) . Multivariate COX regression analysis:High nutritional risk was a risk factor for hospi-talization of hospitalized infants with lower respiratory tract infection ( RR=1. 57, P=0. 024 ) . Conclusion There is a high incidence of high nutritional risk in infants with lower respiratory tract infection. Compared with children with low and moderate nutritional risk, the hospitalization time is longer, the hospitalization cost is in-creased, and the clinical cure rate is lower, which is the risk of clinical outcome. factor. Therefore, it is neces-sary to conduct nutrition risk screening for infants with lower respiratory tract infections, and provide a theoreti-cal basis for clinical nutrition evaluation and nutritional intervention.