Objective: To study the effect of calorie-enriched formula on postoperative catch-up growth in infants with cyanotic congenital heart disease (CHD).
Methods: A total of 100 infants with cyanotic CHD who underwent surgical operation from January to December, 2017, were randomly divided into a high-calorie group (receiving calorie-enriched formula after surgery) and a conventional group (receiving standard formula after surgery), with 50 infants in each group. All infants were followed up for 6 months. The observation indices included body height, body weight, prealbumin, and N-terminal pro-brain natriuretic peptide before surgery, at the time of ventilator weaning and extubation after surgery, and at 1, 3, and 6 months after surgery. Height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) were also assessed. Adverse reactions were recorded for both groups.
Results: There were 25 cases (50%) and 21 cases (42%) of malnutrition in the high-calorie group and the conventional group respectively before surgery (P > 0.05). The nutritional status of the two groups improved 6 months after surgery (P < 0.05). At 6 months after surgery, compared with the conventional group, the high-calorie group had a lower proportion of infants with malnutrition (18% vs 36%, P < 0.05) and also a lower proportation of infants with a WAZ score of < -2 (P < 0.05). The infants with malnutrion in the high-calorie group had higher HAZ, WAZ, and WHZ than those in the conventional group (P < 0.05). No gastrointestinal intolerance was observed in both groups during hospitalization.
Conclusions: Compared with the standard formula, calorie-enriched formula can better help with postoperative catch-up growth in infants with cyanotic CHD.
目的: 探讨高能量密度配方奶粉对紫绀型先天性心脏病（CHD）患儿术后生长追赶的影响。
方法: 前瞻性纳入2017年1~12月行外科手术的紫绀型CHD婴儿100例，随机分配至高能量组（术后给予高能量密度配方奶粉）和常规组（术后给予普通配方奶粉），每组50例，随访观察6个月。观察指标包括术前、术后脱机拔管时、术后1个月、术后3个月、术后6个月的身高、体重、前白蛋白、N末端B型利钠肽原；计算年龄别身高Z评分（HAZ）、年龄别体重Z评分（WAZ）和身高别体重Z评分（WHZ）；同时记录两组不良反应。
结果: 术前高能量组和常规组分别有25例（50%）和21例（42%）营养不良，两组营养不良率差异无统计学意义（P > 0.05）。两组患儿术后6个月营养状况均有改善（P < 0.05）。术后6个月高能量组营养不良率低于常规组（18% vs 36%，P < 0.05）；高能量组WAZ < -2的比例低于常规组（P < 0.05）；高能量组营养不良患儿HAZ、WAZ、WHZ均高于常规组（P < 0.05）。两组患儿住院期间均未出现胃肠道不耐受。
结论: 高能量密度配方奶粉较普通配方奶粉更有助于紫绀型CHD患儿术后生长追赶。