| ObjectiveBy reviewing and analyzing the identification,clinical symptoms,complications and auxiliary examination of moderate-severe malnutrition cases to summarize the clinical characteristics and causes,hoping to improve the diagnosis and treatment.Objects and Methods1.Research objects:inpatient children of moderate-severe malnutrition in Children’s Hospital of Chong Qing Medical University from July 2012 to July 2014.2.Methods:Retrospective analysis the clinical data of the moderate-severe malnutrition cases.3.Statistical analysis:The clinical data was analyzed by the statistical software SPSS 19.0 and Microsoft Office Excel 2003.Results1.958 cases were collected,542 cases(56.6%) were male,416 cases(43.4%) were female.There were no neonate cases,468 cases(48.9%) in 1-6month,187 cases(19.5%) in 6-12month,192 cases(20.0%) in 1-3 years,111 cases (11.6%) in more than 3 years.2.395 cases(41.2%) in moderate malnutrition under 3 years,452 cases(47.2%) in severe malnutrition under 3 years,lll cases(11.6%) in severe malnutrition more than 3 years.3.The birth weight of 903 cases was (2.79±0.66)kg,257 cases(28.5%) in LBW,476 cases(50.2%) in breast feeding,complementary feeding in 4-6 months were 238 cases(53.6%).4.The main clinic symptoms of our group were cough(427/958,44.6%),fever(268/958,28.0%),diarrhea(145/958,15.1%),sho rtness of breath(139/958,14.5%),vomiting(123/958,12.8%),shouting out(86/958,9.0%),weight lose,weight not increase or increase slowly or growth and development behind others(79/958,8.3%),finding CHD or heart murmur(48/958,5.0%).5.552 cases(57.6%) complicated with pneumonia,31 cases (3.2%) complicated with bronchitis,55 cases(5.7%) complicated with infectious diarrhea,75 cases(7.8%) complicated with non-infectious diarrhea.287 cases(30.0%) complicated with CHD,51 cases(5.3%) complicated with cerebral palsy,45 cases(4.7%) complicated with congenital laryngeal cartilage dysplasia,41 cases(4.3%) complicated with thoracic deformity.6.Blood routine test:953 cases white blood cells count were(12.47±7.54)×109/1.559 cases WBC increased,mainly complicated with pneumonia,bronchitis or infectious diarrhea.951 cases platelet count were(394.89±176.90)× 109/L,950 cases Hemoglobin were (105±21.81)g/L, >110g/L were 402 cases(42.3%),-90 g/L were 333 cases(35.1%),-60g/L were 191 cases(20.1%),-30g/L were 21 cases(2.5%),< 30g/L were 3 cases(0.3%).7.The electrolyte:138 cases(15.4%) in hyponatremia,133 cases(14.8%) in hypochloremia,118 cases(13.1%) in hypokalemia,98 cases(10.9%) in hyperkalemia,153 cases(17.0%) in two or more electrolyte disorder.8.Chest radiography showed normal in 90 cases(17.7%),pneumonia in 198cases(39.0%),lung texture increased in 97 cases(19.1%),pneumonia with CHD in 54 cases(10.6%).Echocardiography showed normal in 73 cases(15.5%),atrial septal defect in 158 cases(33.5%),two and more heart defect or complex CHD in 105 cases(22.2%),ventricular septal defect in 22 cases(4.7%).MRI showed normal in 23 cases(23.5%),abnormal in 75 cases(76.5%).EEG showed normal in 61 cases(49.2%),boundaries in 23 cases(18.6%),abnormal in 40 cases(32.2%).ConclusionIn our group,the moderate-severe malnutrition mainly occurs in children under 3 years,birth weight is usually lower than normal children,the breast feeding rate is low and the complementary feeding is improper in some cases.Most of them complained of respiratory infection or diarrhea,may complicate with anemia and electrolyte disorder.The moderate-severe malnutrition may complicate with congenital dysplasia in the same time,such as CHD, congenital laryngeal cartilage dysplasia,cerebral palsy and so on.We can use the clinical manifestation and related auxiliary examination to help find causes and complications to improve the clinical diagnosis and treatment. |
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