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
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
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
诊断性检查
首要检查
- 临床诊断
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
治疗流程
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.
鉴别诊断
- 消瘦
- 慢性营养不良
- 充血性心力衰竭
更多 鉴别诊断指南
- 关于婴幼儿和儿童重度急性营养不良管理的更新
- 世界卫生组织儿童成长标准、婴幼儿及儿童严重急性营养不良的识别
更多 指南
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