Serebral Palsili Çocuklarda Beslenme ve Perkutan Endoskopik Gastrostomi Uygulamaları
Özet
Serebral palsili çocuklarda nöromotor bozukluklar, beslenme ve büyüme süreçlerini ciddi şekilde etkileyerek malnutrisyon ve gelişim geriliği riskini artırır. Multidisipliner bir yaklaşımla yürütülen beslenme takibi ve erken dönemde uygulanan perkutan endoskopik gastrostomi (PEG), çocukların enerji alımını ve yaşam kalitesini önemli ölçüde iyileştirir. Orofarengeal disfonksiyon ve gastroözofageal reflü gibi sık görülen gastrointestinal sorunların yönetimi, hastaların klinik tablosunun düzeltilmesi için kritik öneme sahiptir. PEG uygulaması, beslenme güvenliğini sağlarken hem büyüme sürecini destekler hem de ailelerin bakım yükünü azaltır.
Neuromotor disorders in children with cerebral palsy significantly impair growth and nutritional status, increasing the risk of malnutrition and developmental delay. Multidisciplinary nutritional monitoring and timely percutaneous endoscopic gastrostomy (PEG) significantly improve energy intake and the overall quality of life for these patients. Managing common gastrointestinal issues, such as oropharyngeal dysfunction and gastroesophageal reflux, is critical for optimizing clinical outcomes. PEG intervention effectively ensures nutritional safety, supports healthy growth, and reduces the caregiving burden for families.
Referanslar
Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol 2002; 44: 633-40.
Serdaroğlu A, Cansu A, Ozkan S, Tezcan S. Prevalance of cerebral palsy in Turkish children between 2 and 16 years. Dev Med Child Neurol. 2006; 48: 413-6.
Bell KL, Boyd RN, Tweedy SM, Weir KA, Stevenson RD, Davies PS. A prospective, longitudinal study of growth, nutrition and sedentary behavior in young children with cerebral palsy. BMC Public Health 2010; 10: 179.
Arvedson JC. Feeding children with cerebral palsy and swallowing difficulties. Eur J Clin Nutr 2013; 67: S9-12.
Andrew MJ, Parr JR, Sullivan PB. Feeding difficulties in children with cerebral palsy. Arch Dis Child Educ Pract Ed 2012; 97: 222-9.
Jahromi SR, Togha M, Fesharaki SH, et al. Gastrointestinal adverse effects of antiepileptic drugs in intractable epileptic patients. Seizure 2011; 20: 343-6.
Romano C, van Wynckel M, Hulst J, et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for the evaluation and treatment of gastrointestinal and nutritional complications in children with neurological impairment. J Pediatr Gastroenterol Nutr 2017; 65: 242-64.
Rempel G. The importance of good nutrition in children with cerebral palsy. Phys Med Rehabil Clin N Am 2015; 26: 39-56.
Brooks J, Day S, Shavelle R, Strauss D. Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts. Pediatrics 2011; 128: e299-307.
Stallings VA, Cronk CE, Zemel BS, Charney EB. Body composition in children with spastic quadriplegic cerebral palsy. J Pediatr 1995; 126: 833-9.
Gurka MJ, Kuperminc MN, Busby MG, et al. Assessment and correction of skinfold thickness equations in estimating body fat in children with cerebral palsy. Dev Med Child Neurol 2010; 52: e35-41.
Samson-Fang L, Butler C, O'Donnell M; AACPDM. Effects of gastrostomy feeding in children with cerebral palsy: an AACPDM evidence report. Dev Med Child Neurol 2003; 45: 415-26.
Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Oropharyngeal dysphagia and cerebral palsy. Pediatrics 2017; 140: e20170731.
Trivic I, Hojsak I. Evaluation and treatment of malnutrition and associated gastrointestinal complications in children with cerebral palsy. Pediatr Gastroenterol Hepatol Nutr 2019; 22: 122-31.
Kuperminc MN, Gottrand F, Samson-Fang J, et al. Nutritional management of children with cerebral palsy: a practical guide. Eur J Clin Nutr 2013; 67: S21-3.
Homan M, Hauser B, Romano C, et al. Percutaneous endoscopic gastrostomy in chil67: S9-12dren: an update to the ESPGHAN position paper. J Pediatr Gastroenterol Nutr 2021; 73: 415-26.
