Nurcan BAĞLAM, Emine YILDIZ, ELİF ACAR ARSLAN, Güzide TURANLI

Nörolojik Yutma Bozukluğu Olan Çocukların Besin Tüketim Durumlarının Değerlendirilmesi

Amaç: Çalışmanın amacı nörolojik yutma bozukluğu olan çocukların beslenme şekli ile enerji, makro ve mikro besin ögesi alım durumlarını değerlendirmektir. Bireyler ve Yöntem: Hacettepe Üniversitesi Tıp Fakültesi Pediatrik Nöroloji Bilim Dalı izleminde yutma bozukluğu tanısı almış 1-10 yaş arası nörolojik hastalığı olan 96 çocuk hasta çalışmaya alınmıştır. Hastaların genel bilgileri, beslenme şekli ve 24 saatlik besin tüketim kayıtları alınarak antropometrik ölçümleri yapılmıştır. WHO 2006 ve WHO 2007 büyüme standartlarına göre, yaşa göre vücut ağırlığı Z skor değeri -2SD altında olanlar malnütrisyonlu olarak kabul edilmiştir. Besin tüketimleri ve kullandıkları beslenme destek ürünleri BeBİS 7.2 programı kullanılarak analiz edilmiştir. Günlük alınan enerji ve besin ögeleri,Türkiyeye Özgü Beslenme Rehberinde belirtilen yaş grubuna göre önerilen miktarlar ile karşılaştırılarak yeterlilik düzeylerine bakılmıştır. Bulgular: Hastaların yaş ortalaması 3.8±2.4 yıldır (1-9.4 yıl). Çalışmada yer alan 96 hastanın %56.2si erkek, %43.8i kızdır ve çocukların %50si malnütrisyonludur. Çocuklar beslenme tipine göre yalnızca oral, hem oral hem enteral ve yalnızca enteral yol ile beslenenler şeklinde 3 gruba ayrılmıştır. Bu gruplamaya göre hastaların %43.7si yalnızca oral, %14.6sı hem oral hem enteral, %41.7si ise yalnızca enteral yolla beslenmektedir. Hastaların beslenme destek ürünü kullanma oranı ise %69.8dir. Araştırmada yer alan erkek çocukların günlük alması gereken enerjinin %70.4ünü, kız çocukların ise %61.6sını karşıladığı saptanmıştır (p>0.05). Erkek çocukların günlük protein gereksinimlerinin %145.3ünü, kız çocukların ise %127.9unu karşıladığı sonucuna varılmıştır (p>0.05). Günlük posa alımı için ise çocukların gereksinmenin %23.3ünü karşıladığı saptanmıştır. Sonuç: Büyüme gelişme döneminde besin ögesi ihtiyacındaki artış ve uygun besin ögelerini sağlama konusunda sorun yaşamaları nedeniyle nörolojik yutma bozukluğu olan çocuklar malnütrisyon riski altındadır.

Assessment of Dietary Intakes in Children with Neurological Dysphagia

Aim: The aim of this study was to evaluate feeding type, energy, macronutrients and micronutrients intake of children with neurological dysphagia. Subjects and Methods: A total of 96 children aged 1 to 10 years followed by Hacettepe University Faculty of Medicine, Department of Pediatric Neurology with a diagnosis of dysphagia related to their neurological disorder were included. General information about the children, feeding methods and 24-hour dietary recalls were obtained, anthropometric measurements were evaluated. According to the WHO 2006 and WHO 2007 Growth Standards, patients whose weight-for-age Z score values under -2 SD were determined to be underweight. Food consumption and nutritional support formulas intake were analyzed by using BeBİS 7.2 programme. Adequacy of age specific recommended intakes of energy and nutrients were evaluated according to Dietary Guidelines for Turkey. Results: The mean age was 3.8±2.4 years (1-9.4 years). Out of 96 patients examined, 56.2% were boys and 43.8% were girls and 50% of children were underweight. When children were classified into 3 groups according to their feeding type; it was shown that 43.7% of patients were orally fed, 14.6% were both orally and tube fed, 41.7% were only tube fed. The ratio of using nutritional support formula was found as 69.8%. In this study, boys consumed 70.4% and girls consumed 61.6% of recommended daily energy intake (p>0.05). It was also found that boys consumed 145.3% and girls 127.9% of recommended daily protein intake (p>0.05). In addition, it was determined that children consumed %23.3 of recommended daily fiber intake. Conclusion: Due to increase in nutritional requirements during growth and development period and also having difficulties providing adequate nutrients, dysphagic children are under the risk of malnutrition.

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