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恶性营养不良病

最后审阅: 10 Nov 2024
最后更新: 19 Jan 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 饥荒史或饮食单一
  • 居住在农村地区的 <5 岁儿童
  • 身高别体重、年龄别身高 z 评分低或上臂中部臂围(MUAC)结果偏低
  • 双向性凹陷性水肿
完整详情

其他诊断因素

  • 毛发变色
  • 皮肤炎症/溃疡
  • 情绪冷漠、无食欲
  • 体温过低
  • 口腔假丝酵母
  • 干眼病
  • 苍白
  • 体内水分较少
  • 发热
  • 易激惹
完整详情

危险因素

  • 粮食不安全状况严重或饥荒盛行
  • 农村地区
  • <5 岁
  • 以玉米或木薯为主食的单一膳食结构
  • 膳食中缺乏蛋白质
  • HIV
  • 结核病 (TB)
  • 麻疹
  • 腹泻
  • 断奶
  • 暴露于自由基中
  • 抗氧化剂缺乏
  • 黄曲霉毒素中毒
  • 免疫接种不完整
  • 社会条件或经济条件差
  • 脑瘫
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诊断性检查

首要检查

  • 临床诊断
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需考虑的检查

  • 尿试纸(试验)
  • 全血细胞计数 (FBC)
  • 血清电解质
  • 血清蛋白
  • 血清白蛋白
  • 血糖
  • 胸部 X 线检查 (CXR)
  • 尿液培养
  • 血液培养
  • 粪便培养
  • 结核 (TB) 皮肤试验
  • HIV 血清学/聚合酶链反应 (PCR)
  • 疟疾筛查
  • 超声心动图
完整详情

治疗流程

急症处理

非复杂性

复杂性

撰稿人

作者

Mark J. Manary, MD

Helene B. Roberson Professor of Pediatrics

Washington University School of Medicine

St Louis

MO

利益声明

MJM is an author of a number of references cited in this topic.

Indi Trehan, MD, MPH, DTM&H

Associate Professor of Pediatrics

Adjunct Associate Professor of Global Health and Epidemiology

University of Washington

Seattle

WA

利益声明

IT is the co-author of a reference cited in this topic.

鸣谢

Dr Mark J. Manary and Dr Indi Trehan would like to gratefully acknowledge Dr James E.G. Bunn, the previous contributor to this topic.

利益声明

JEGB declared that he had no competing interests.

同行评议者

Beatrice Amadi, MD, MMed.Paed

Consultant Paediatrician

University Teaching Hospital

Department of Paediatrics and Child Health

Lusaka

Zambia

利益声明

BA declares that she has no competing interests.

Tahmeed Ahmed, MD

Adjunct Professor

Public Health Nutrition

James P. Grant School of Public Health

BRAC University

Dhaka

Bangladesh

利益声明

TA declares that he has no competing interests.

George J. Fuchs III, MD

Professor of Pediatrics and Health Policy and Management

University of Arkansas for Medical Sciences

Little Rock

AR

利益声明

GJF declares that he has no competing interests.

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