Dissertação

Perfil nutricional (antropométrico e bioquímico) de crianças atendidas no programa de fibrose cística a nível ambulatorial em um hospital universitário de Belém do Pará

Maintaining adequate nutritional status is essential for a good prognosis in cystic fibrosis (CF). Chronic malnutrition with delayed weight gain and growth is a known problem in patients with cystic fibrosis. Inadequate weight gain is caused by a negative energy balance resulting from chronic respir...

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Autor principal: LOPES, Maura Fabíola de Lima
Grau: Dissertação
Idioma: por
Publicado em: Universidade Federal do Pará 2018
Assuntos:
Acesso em linha: http://repositorio.ufpa.br/jspui/handle/2011/10095
Resumo:
Maintaining adequate nutritional status is essential for a good prognosis in cystic fibrosis (CF). Chronic malnutrition with delayed weight gain and growth is a known problem in patients with cystic fibrosis. Inadequate weight gain is caused by a negative energy balance resulting from chronic respiratory disease, malabsorption of nutrients and metabolic increase. Depending on the evolution and severity of nutritional status, several intervention proposals are made. Today, the attention to nutrition is considered as a priority in attention to cystic fibrosis patient. Maintaining adequate nutritional status is a key aspect in the treatment of CF patients. One of nutritional assessment objectives is the early detection of those children who are at nutritional risk. The evolution of the diet of a child can prevent change their nutritional status and biochemical long before they find themselves obvious clinical signs of deficiency. Four types of nutritional interventions can be programmed in CF patients: behavioral changes, oral therapy, enteral nutrition and parenteral nutrition. This paper aims to describe the nutritional status of children treated at the Cystic Fibrosis program at a university hospital in Belém-PA. We conducted a retrospective cross-sectional study with children of both genders and aged 1-10 years who have a confirmed diagnosis of cystic fibrosis who were enrolled in the CF Program HUJBB / UFPA. Data collection occurred in the four-month period (September 2014 to December 2014). These data were collected for the period: 2012-2013 all records of children belonging to the FC program. To determine the nutritional status was used anthropometric parameters. Anthropometric measurements were collected from medical records the weight and height, and the combination of these two measures was expressed through the indicators and analyzed according to age and sex. That the nutritional status indicators so were weight / age (W / A), height / age (H / A), which were analyzed based on the tables of the WHO curves (2006), for children under 5 years and curves WHO (2007) for children 5-19 years, and the Z-score for both. THE biochemical indicators were: glucose, total cholesterol, HDL, LDL, triglycerides, serum iron, SGOT, SGPT and fecal fat research. The study sample consisted of 54 individuals with a mean age 76.67 ± 26.44 months. According to the results there was a distribution of 67% of male children and 51.88% of patients had a diagnosis of normal weight and adequate stature, according to weight / age and height / age, respectively. However, was not statistically significant when comparing the two anthropometric indices, according to the chi-square, that is, there is no dependency between them. According naturalness of patients with cystic fibrosis was found that the city of Belém, the capital has the highest number of people with the disease, accounting for 70.37% of the total. The enteral supplementation of patients with cystic fibrosis evaluated in reference hospital it appears that 92.59% of patients make use of supplementation; Statistically significant (p <0.01). The 10 biochemical variables no significant dependencies between them. However, glucose values, SGOT, SGPT, total cholesterol, HDL-C, LDL-C and triglycerides remained within normal standards. It is found that 96.30% of patients had infection framework, and respiratory were more evident. In addition, 77.78% use enzyme replacement. Among the patients evaluated, 72.22% had a history of hospitalization and 11.11% had difficulty feeding. The fecal fat test was positive for 57.40% of cases, but it was not statistically significant to characterize the sample according to serum iron is noted that 75.92% had normal; while 24.08% had results below the reference standard, featuring a ferric depletion; with significant statistical dependence between the analyzed variable (p value <0.01). It was observed that patients are eutrophic and biochemical tests within normality patterns due to adherence to treatment, the use of enzymes, good food with added enteral supplementation when necessary.