Prospective Evaluation of Weight Gain in Both Nonorganic and Organic Failure‐to-Thrive Children: An Outpatient Trial of a Multidisciplinary Team Intervention Strategy
Prospective Evaluation of Weight Gain in Both Nonorganic and Organic Failure‐to-Thrive Children: An Outpatient Trial of a Multidisciplinary Team Intervention Strategy
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非器质性和器质性发育不良儿童体重增加的前瞻性评估：多学科团队干预策略的门诊试验
DOI：
10.1097/00004703-198902000-00006
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发表时间：
1989
影响因子：
2.4
通讯作者：
Ann Munier
中科院分区：
文献类型：
--
作者：
W. Bithoney;J. Mcjunkin;Joanne Michalek;Harwood S. Egan;J. Snyder;Ann Munier
不兴旺(FTT)分为有机(OFTT)和非有机(NFTT)。传统上，人们被教导，患有OFTT的儿童即使得到适当的护理(卡路里、养成、医疗监护)也不能生长良好，而NFTT儿童在得到充分护理的情况下会生长良好。我们进行了这项研究，以确定NFTT和OFTT儿童在接受专门的多学科团队治疗时是否可以以类似的速度成长，该团队提供具体的、个性化的治疗，包括心理支持、医疗护理和高热量饮食。转诊至本院门诊FTT咨询诊所的86名儿童中，患有NFTT，22名患有OFTT。生长商数分析用于确定6个月随访期内的生长结果。与生长曲线平行的生长速度产生的GQ等于1。增长速度比预期快2倍的GQ=2。两组孩子都生长得非常好。NFTT组GQ=1.67±0.56(SD)，OFTT组GQ=1.81±0.37(SD)，P=NS。当给予足够的卡路里以追赶生长时，OFTT儿童的生长发育与NFTT儿童一样好。我们的数据表明，仅靠体重增加并不能像传统上教导的那样可靠地区分OFTT和NFTT。他们建议我们尽一切努力最大化FTT儿童的卡路里摄入量。他们还建议，由儿科医生、儿童精神病学家、营养学家、护士临床医生和社会工作者组成的多学科团队可能在管理FTT儿童方面取得成功。
Failure-to-thrive (FTT) is categorized as organic (OFTT) or nonorganic (NFTT). Traditionally, it has been taught that children with OFTT are unable to grow well in spite of adequate care (calories, nurturance, medical supervision), whereas NFTT children will grow well when given adequate care. We undertook this study to determine whether NFTT and OFTT children could grow at similar rates when treated by a specialized multidisciplinary team that provided concerete, individualized therapies including psychosical support, medical care, and hypercaloric diets. Eighty-six children were enrolled on referral to our outpatient FTT consultative clinic; 64 had NFTT and 22 had OFTT. Growth quotient analysis was used to determine growth outcomes over a 6-month follow-up period. Growth at a rate paralleling the growth curve produces a GQ equal to 1. Growth 2 times as rapid as expected gives a GQ = 2. Children in both groups grew extremely well. For NFTT, GQ = 1.67 ± 0.56 (SD); for OFTT, GQ = 1.81 ± 0.37 (SD), p = NS. OFTT children grew just as well as NFTT children when given adequate calories for catch-up growth. Our data indicate that weight gain alone cannot reliably differentiate OFTT from NFTT, as has been traditionally taught. They suggest that we make every attempt to maximize caloric intake in FTT children. They also suggest that a multidisciplinary team consisting of a pediatrician, child psychiatrist, nutritionist, nurse clinician, and social worker may be successful in managing FTT children.