Therapeutic measures depend on the type of dystrophy andthe degree of its severity. First of all, they include the elimination of etiological factors, organization and mode for optimal child environment. Diet therapy is paramount. Also needed readjustment of foci of chronic infection, treatment of opportunistic diseases, prevention of secondary infections, fight against physical inactivity.
Children with malnutrition I degree treated at home undersupervision of the district pediatrician without changing the normal mode corresponding to their age. Treatment of children with malnutrition grade II and III is carried out in a hospital with a mandatory organization gentle treatment: the child should be protected from all unnecessary stimuli (light, sound, etc.). It is desirable content of the child in the box with the creation of optimal microclimate (air temperature 27-30 ° C, humidity 60-70%, frequent airing); mother hospitalized with the child. While walking the child to keep on hand, ensure that hands and feet are warm (use hot water bottles, socks, mittens). Increased emotional tone should ensure gentle treatment of the patients, the use of massage and gymnastics. When malnutrition III degree, especially in muscular hypertonicity, massage is carried out with great care and only stroking.
Diet is the basis of rational treatment dystrophy (especially malnutrition). Diet therapy can be divided into two stages:
- finding tolerability of various foods;
- a gradual increase in the volume of food and its quality correction to achieve physiological age norm.
The first phase lasts from 3-4 to 10-12 days, the second - until recovery.
General principles of diet therapy, recommended in the treatment of dystrophies:
- "Rejuvenation" of the diet - the use of food intended for younger children (breast milk, sour milk adapted formulas based on protein hydrolysates);
- split meals - frequent feeding (for example, up to 10 times a day with malnutrition III degree) with a decrease in the amount of one meal;
- weekly food calculation load amount of proteins, fat and carbohydrates with correction according to the increase of body weight;
- regular monitoring of the correctness of treatment (maintenancefood diary with an indication of the amount of food, drink fluids, urine output and stool characteristics; drawing up "weight curve", scatological study and others.).
Calculation of power when I degree malnutrition performon is meant to (age-appropriate) body weight of the child to the full satisfaction of their needs in basic food components, trace elements and vitamins. When malnutrition II and III degrees in the first 2-3 days of food is limited to the amount of 1 / 3-1 / 2 for a would weight. Subsequently, it gradually increased to 2 / 3-3 / 5 of the daily diet of a healthy child. The missing volume of fill fluid power - vegetable and fruit juices, 5% glucose solution. Upon reaching the age laid the volume of food the amount of protein and carbohydrates is meant to rely on the body mass and fat - the actual. If a child in the process of increasing the amount of food there dyspepsia, and weight increase (usually within 1 - 12 days after the start of treatment), gradually spend quality food correction, all of the ingredients is meant to rely on the body mass (protein and fat - 4-4 5 g / kg, carbohydrates - 13-16 g / kg).
Enzymes necessarily prescribed for any degree ofmalnutrition due to a larger load at the treatment of food, as well as due to decreased activity of the gastrointestinal tract of the patient's own enzymes. Fermentoterapii spend a long time, replacing preparations: rennet (abomin), pancreatin + bile components + hemicellulase (Festal), with a large number of neutral fat and fatty acids in coprogram - pancreatin panzinorm. Pathogenetically grounded and application of vitamins, particularly ascorbic acid, thiamine and pyridoxine. Stimulating therapy comprises alternating courses of royal jelly (apilak) pentoksila, ginseng and other means. With the development of infectious disease is administered Ig.