Рефидинг-синдром и его профилактика у больных нервной анорексией

Abstract

Aim. To study the condition of the problem, the prevalence and severity of dyselectrolytemia, as a possible manifestation of the syndrome of renewal of nutrition (refeeding syndrome) in patients with anorexia nervosa (AN). Materials and methods. We studied somatometric indicators and the prevalence of electrolyte disturbances of 81 women aged from 18 to 55 years, who were treated in the somato-psychiatric department of the Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Results. Hypotrophy predominates as marasmus (95.2%) in the early stages of AN. At the later stages of development of AN, the frequency of mixed hypotrophy by the type of marasmatic kwashiorkor increases significantly (up to 63.2%), which is manifested by a decrease not only in somatometric indices, but also in depletion of the visceral protein pool. When studying the frequency of electrolyte disturbances, hypokalemia was most often observed in patients with NA in the initial period of realimentation (14.8%). At the same time, its moderately expressed degree prevailed. Moderate hypophosphatemia (not less than 0.6 mmol/L), which may indicate a latent manifestation of refeeding syndrome, was relatively often (21.1%) observed in patients with severe malnutrition (body mass index less 12.5 kg/m²). Hypomagnesemia for the entire period of observation of patients with various stages of the disease were not detected. Conclusion. Diselectrolytemia is often observed in patients with AN during their refeeding, which requires regular dynamic monitoring of serum potassium, magnesium and phosphate levels and timely correction of their deficiency.