| Intractable Diarrhea in Early Infancy : Clinical Features on Admission and A Nutritional Management |
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Jong Won Shin, Kyung Won Hwang, Young Ho Ahn, Jin Bok Hwang, Chang Ho Han, Hai Lee Chung, Young Dae Kwon |
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Department of Pediatrics, Taegu Catholic University School of Medicine, Taegu, Korea |
| 생후 3개월내에 발생한 영아기 난치성 설사 환아의 임상소견 및 치료방침에 관한 임상적 고찰 |
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신종원, 황경원, 안영호, 황진복, 한창호, 정혜리, 권영대 |
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대구가톨릭대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: We studied to assess the value of clinical findings on admission in screening of intractable diarrhea in early infancy(IDI) and the efficiency of early trial of semi-elemental form-ula (protein hydrolysate) as a nutritional management in IDI.
Methods
: We carried out a retrospective review of medical records of twenty-eight early infants with diarrhea and malnutrition who were diagnosed as IDI at Department of Pediatrics, Taegu Catholic University Hospital between January 1990 and May 1993.
Results
: 1) The mean age of the patients was 28.914.5(10 - 86)days. The duration of diarrhea on admission was 66.1(1 - 30)days. Twenty-four cases(85%) were below 3 percentile in body weight on admission and no patients was fed breast milk over 7 days after birth.
2) Laboratory data on admission showed serum protein level 4.80.5(3.7 - 6.1) g/dl, serum albumin level 2.20.3(1.8 - 3.3)g/dl, serum bicarbonate level 11.35.7(2.7 - 22.3) mEq/L and band form of leukocytes on the peripheral blood smear was 23.715.6(4 - 64) %.
3) Necrotizing enterocolitis was developed in 5(18%) cases and the incidence was much more common in patients with 'Not-Tried' or 'Not-Early Tried' of semi-elemental formula as a nutritional management(p<0.05).
4) 'Early Tried' patients with semi-elementa formula showed rapid improvement in body weight and thriving, early remission, lower incidence of necrotizing enterocolitis and motality than other groups(p<0.05).
Conclusion
: IDI must be considered and early trial of semi-elemental formula can be recommended if a young infant suffered from diarrhea and malnutrition shows features of ① body weight<3 percentile ②serum albumin<3.0g/dl ③ band neutrophil>5% on peripheral blood smear on admission. |
| Key Words:
Early infancy, Intractable, Diarrhea, Protein hydrolysate |
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