Investigation Of Nutritional Status In Ventricular Septal Defect Infants And Its Influence Factors Before And After Surgery

Background:Evidences demonstrated that congenital heart disease children suffer from malnutrition constantly. Malnutrition will result in more frequent hospitalization, worse operative prognosis, growth obstruct and higher mortality rate. Only knowing the nutritional status and its influential factors before and after surgery can probe into the effective intervention measures to improve the nutritional status of congenital heart disease children. However, it is lack of domestic reseraches about the nutritional status after surgery and its influential factors before surgery. As ventricular septal defect is representative in non-cyanotic congenital heart disease, it is necessary to explore the nutritional condition and its influential factors in ventricular septal defect infants before and after surgery.Objective:To investigate the nutritional status in ventricular septal defect infants before and after surgery and to analyze its influence factors.Methods:A descriptive design was employed in this study. Convenient sampling was used to recruit outpatients who visit the Fu Wai hospital. Total143ventricular septal defect infants were cruited into an investigation of months, height and weight to assess the nutritional status with Z score method before surgery and their mothers were asked to fill a series of questionnaires at the clinic, including demographic questionnaire, preoperative treat history questionnaire, feeding intolerance questionnaire,3-day diet diary and the knowledge, attitude, activities questionnaires of feeding congenital heart disease infants. Preoperative events questionnaire was filled by researcher. The height and weight of child, the feeding intolerance,3-day diet, the knowledge, attitude, activities of feeding congenital heart disease infants were also investigated at three points: first month, third month and sixth month after surgery.Results:①The average of Z score of length/height for age, Z score of weight for age, Z score of weight for length/height were (-0.76±1.41),(-1.52±1.52),(-1.29±1.54) before surgery. The average of Z score of length/height for age, Z score of weight for age, Z score of weight for length/height were (-0.43±1.34),(-1.23±1.57),(-1.25±1.61) first month after surgery. The average of Z score of length/height for age, Z score of weight for age, Z score of weight for length/height were (-0.17±1.20),(-0.29±1.39),(-0.23±1.44) third month after surgery. The average of Z score of length/height for age, Z score of weight for age, Z score of weight for length/height were (-0.23±1.06),(-0.24±1.30),(-0.4±1.41) sixth month after surgery.②The incidence of malnutrition, acute malnutrition and chronic malnutrition were50.3%,44.1%,21%before surgery; the incidence of malnutrition, acute malnutrition and chronic malnutrition were41.8%,38.1%,11.2%first month after surgery, the incidence of malnutrition, acute malnutrition and chronic malnutrition were19.4%,17.1%,4.7%third month after surgery; the incidence of malnutrition, acute malnutrition and chronic malnutrition were8.7%,6.3%,4.0%sixth month after surgery.③Logistic analysis showed that the influential factors of nutritional status before surgery in ventricular septal defect infants were birth weight, pulmonary artery pressures, dietary intake and acquisition of nutritional information by internet or books; the influential factors of nutritional status first month after surgery were child’s age, birth weight, dietary intake and preoperative malnutrition; the influential factors of nutritional status third month after surgery were birth weight, preoperative complications, feeding activities of mothers and preoperative malnutrition; the influential factors of nutritional status sixth month after surgery were birth height and feeding difficulties after surgery.Conclusions:There is a high incidence of malnutrition in ventricular septal defect infants before surgery. After surgery the nutrition status of ventricular septal defect infants were improved significantly and were normal at sixth month after surgery. Nurses should know the nutritional status and its influence factors of VSD infants before and after surgery. Nurses could educate the malnutritional child’s parents with the scientific feeding knowledge to improve the nutritional status of child before surgery, and they could take effective guidance to help parents improving the feeding ability and the dietary intake of infants.