Abstract:

Objective To understand the changing trend of nutritional status of children undergoing liver transplantation within 6 months after discharge，and to explore its influencing factors，in order to provide guidance for the clinical formulation of personalized nutritional intervention programs. Methods By the convenient sampling method，153 children undergoing liver transplantation admitted to the liver transplantation center of a tertiary A hospital in Hangzhou from January 2023 to January 2024 were selected as the research subjects. Their basic and clinical data were collected. The nutritional status at the 1 day before surgery and 1 month，3 months，and 6 months after discharge was evaluated by the standard deviation evaluation method of children’s nutritional status. According to the changing trend of their nutritional status，they were grouped. Univariate and multivariate Logistic regression were used to analyze the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation. Results A total of 144 children who underwent liver transplantation were ultimately included in the study. The incidence of malnutrition at 1 month，3 months，and 6 months after discharge was 66.0%，54.9%，and 53.5%，respectively. According to the changing trend of nutritional status of children undergoing liver transplantation，they were divided into 3 groups：54 cases（37.5%） in the good nutritional status group，24 cases（16.7%） in the fluctuating nutritional status group，and 66 cases（45.8%） in the poor nutritional status group. The results of multivariate Logistic regression analysis showed that birth weight，feeding method within 6 months after birth，age of caregivers and learning situation of nutritional knowledge were the influencing factors of the changing trend of nutritional status in children undergoing liver transplantation（P<0.05）. Conclusion The incidence of malnutrition in children undergoing liver transplantation is high within 6 months after discharge； medical staff should closely collaborate with families to formulate and implement staged personalized nutritional intervention measures based on the specific conditions and influencing factors of the children to effectively improve the nutritional status of the children after transplantation.

Key words: Liver Transplantation, Nutritional Evaluation, Root Cause Analysis, Pediatric Nursing

摘要：

目的 了解肝移植手术患儿出院后6个月内的营养状况变化趋势并探讨其影响因素，为临床制订个性化的营养干预方案提供指导。 方法 采用便利抽样法，于2023年1月—2024年1月，选取在杭州市某三级甲等医院肝移植中心行肝移植手术的153例患儿为调查对象，收集其基本资料及临床资料，通过儿童营养状况的标准差评价方法评估其术前1 d及出院后1、3、6个月的营养状况，并根据其营养状况变化趋势进行分组分析。采用单因素分析和多因素Logistic回归分析肝移植患儿术后营养状况变化的影响因素。 结果 最终纳入144例肝移植患儿。肝移植患儿出院后1、3、6个月时营养不良发生率分别为66.0%、54.9%和53.5%。根据肝移植患儿营养状况变化趋势分为营养状况良好组54例（37.5%）、营养状况波动组24例（16.7%）、营养状况不良组66例（45.8%）。多因素Logistic回归分析结果显示，出生体重、出生后6个月内喂养方式、照顾者年龄及营养知识学习情况是肝移植患儿术后发生营养状况变化的影响因素（P<0.05）。 结论 肝移植患儿出院后6个月内营养不良发生率高，医护人员应与家庭紧密合作，依据患儿的具体情况和影响因素，制订并实施阶段性的个性化营养干预措施，有效改善移植患儿术后的营养状况。

关键词: 肝移植, 营养评价, 影响因素分析, 儿科护理学