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家有小胖孩 别忙着说“身体好”

2019-07-18 22:30:15 来源: 京晨晚报 作者:
摘要: 张田 钱艺 曾几何时,“胖嘟嘟的小脚丫”是家长眼中把孩子养得好的一项重要标准。但随着现代人生活饮食水平的提高,“胖嘟嘟”还意味着疾病的潜伏

 

    张田 钱艺

曾几何时,“胖嘟嘟的小脚丫”是家长眼中把孩子养得好的一项重要标准。但随着现代人生活饮食水平的提高,“胖嘟嘟”还意味着疾病的潜伏。家长们虽然知道太胖不好,却不了解怎样界定孩子是不是“肥胖”。不少孩子来医院就诊时已达到重度肥胖水平,并且出现了并发症。

目前国际公认的儿童肥胖诊断标准,主要依据质量指数(BMI),即体重(kg)/身高(㎡)的比值来判定。BMI值在同年龄同性别儿童的第95百分位及以上即可诊断为肥胖症;BMI在第85百分位至第95百分位之间的儿童属于超重范围,提示家长重视,避免发展为肥胖症。

从临床情况来看,肥胖给儿童带来的疾病大致有这样几类。

 糖尿病

肥胖儿童大多喜爱甜食、油炸食品等高糖高热量饮食,且进食量较大。这种情况下他们的身体需要分泌大量的胰岛素来维持血糖稳定,从而容易引发高胰岛素血症,导致胰岛功能异常,罹患2型糖尿病的概率将明显提高。

糖尿病属于慢性疾病,需要长期口服药物或注射胰岛素治疗。这严重影响到儿童的生活质量,还容易引发全身各处血管、神经的并发症,严重时可能导致视力损害和肢体活动障碍,以及酮症酸中毒、高渗性昏迷等急性严重并发症。

高血压

 高血压是肥胖的另一个常见并发症。研究发现,肥胖与儿童高血压关系密切,约50%的儿童高血压患者存在肥胖问题,而肥胖儿童6年后高血压的发病率是正常体重儿童的4-5倍。

肥胖儿童的脂肪组织包裹在心脏和血管壁周围,好比给它们穿上了一件厚厚的“贴身棉服”,使循环系统长期处于高负荷状态,易引发心脏病、肾病、脑血管疾病等多种并发症,危害巨大。

 因此,肥胖儿童应避免高盐、高脂饮食,养成定期监测血压的习惯。如发现血压问题,出现头晕、头痛等可疑症状应及时就医。

肺功能损害

前面提到,小胖孩的脂肪组织就像一件厚厚的“贴身棉服”,虽然保温,却也束缚了身体的正常活动。肥胖儿童由于胸、腹壁脂肪组织过多,胸廓和膈肌的运动受限,呼吸起来会比体格正常的孩子费力,尤其是夜间仰卧位时更为明显。

长此以往,身体得不到足够的氧气,体内产生的二氧化碳等气体又不能顺利排出,就容易造成肺功能损害,引发低氧血症和高碳酸血症等疾病

 睡眠呼吸障碍

同样,肥胖儿童的脂肪组织堆积在舌部和咽部,会导致气道狭窄,夜间睡眠时容易出现通气不足,甚至呼吸暂停,降低睡眠质量。

孩子夜里睡不好,白天打瞌睡,注意力不集中,学习效率下降。睡眠质量下降还会导致内分泌紊乱,生长激素分泌不足,影响正常生长发育。同时,肥胖儿童体育活动减少,在进一步加重肥胖的同时,还造成免疫力下降,负面表现之一就是反复呼吸道感染。

 如果发现肥胖儿童有夜间打鼾、张口呼吸、憋醒等情况,需要警惕睡眠呼吸障碍,及时就医。

血脂异常及脂肪肝

脂肪组织是无孔不入的“小怪兽”,血液系统也逃不出它们的“魔掌”。肥胖儿童常常合并有高脂血症,当厚厚的脂肪堆积在血管壁时,就会形成斑块,引起血管狭窄、动脉硬化,甚至导致心脑血管疾病。  肝脏是进行物质代谢的重要脏器,其中也包括脂肪代谢。当血液中过多的游离脂肪酸被运往肝脏,超过肝脏代谢能力时,大量脂肪就会堆积在肝内,导致脂肪肝,严重者会合并肝炎,对肝功能造成不可逆的损害。

肥胖的本质是脂肪组织的过度增生。如果把与肥胖相关的疾病比喻成一支“敌军”,那么肥胖就是它们的“总司令”,同时也是“急先锋”。一旦身体被肥胖打倒,后面的疾病就会一拥而上。幸运的是,肥胖并不难对付。家有胖孩儿的家长,一定要带领孩子行动起来,健康饮食、规律作息、适当运动、疏导心理,严重者及时就医,在医生指导下达到控制体重的目的。

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