Abstract:

The nutritional management of a child with very early-onset inflammatory bowel disease during umbilical cord blood stem cell transplantation is summarized. The key points of nursing care are as follows. Before hematopoietic stem cell transplantation，multiple methods were combined to conduct early nutritional screening and assessment to clearly identify the status of malnutrition，a personalized enteral nutrition plan was developed to reduce discomfort symptoms，and trace elements and vitamins were supplemented to maintain the balance of the internal environment. During chemotherapy period and transplantation period， parenteral nutrition protocols were initiated to alleviate gastrointestinal reactions during chemotherapy. After hematopoietic stem cell transplantation，personalized transition strategies were implemented，and extraenteral and enteral nutrition were promoted；the complementary foods were added as required to meet the developmental needs；based on multidisciplinary collaboration，the transition from tube feeding to oral feeding is achieved. After 153 days of treatment and nursing care，the child’s IL-10 signaling pathway function returned to normal，the nutritional status was improved，and catch-up growth was achieved.

Key words: Early-Onset Inflammatory Bowel Disease, IL-10 Mutation, Umbilical Cord Blood Stem Cell Transplantation, Nutritional Management, Pediatric Nursing

摘要：

总结1例极早发型炎症性肠病患儿行脐血干细胞移植期间的营养管理，护理要点如下。造血干细胞移植前：联合多种方式早期开展营养筛查与评定，明确营养不良状态；制订个性化的肠内营养方案，减少不适症状；补充微量元素和维生素，维持内环境平衡。化疗期和移植期：启动肠外营养方案，缓解化疗期间胃肠道反应。造血干细胞移植后：实施个性化的过渡策略，推进肠外营养转向肠内营养；按要求增添辅食，满足发育需求；基于多学科协作，实现从管饲到经口喂养的过渡。经过153 d的治疗和护理，患儿白介素-10信号通路轴功能恢复正常，营养状况得到改善并实现追赶生长。

关键词: 极早发型炎症性肠病, 白介素-10突变, 脐血干细胞移植, 营养管理, 儿科护理学