中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (7): 564-568.DOI: 10.19538/j.ek2026070605

• 专题笔谈 • 上一篇    下一篇

从罗马Ⅴ诊断标准看儿童功能性喂养困难的诊治

  

  1. 郑州大学附属儿童医院  河南省儿童医院郑州儿童医院消化内科，河南  郑州  450018
  • 出版日期:2026-07-06 发布日期:2026-09-17
  • 通讯作者: 李小芹，电子信箱：15890105818@163.com

Diagnosis and treatment of pediatric functional feeding disorders based on Rome V diagnostic criteria

  1. Department of Gastroenterology，Children’s Hospital Affiliated to Zhengzhou University，Henan Children’s Hospital Zhengzhou Children’s Hospital，Zhengzhou  450018，China
  • Online:2026-07-06 Published:2026-09-17

摘要： 功能性喂养困难可显著影响儿童营养状况、生长发育和生活质量。罗马Ⅴ标准将其归入儿童上消化道肠-脑互动异常（disorders of gut-brain interaction，DGBI），并在功能性儿童喂养困难（functional pediatric feeding disorders，FPFDs）框架下提出高敏感性吞咽困难、预期性限制喂养、饥饿失调进食紊乱和医疗因素相关功能性喂养困难4 个亚型，强调喂养困难不仅是行为问题，更是胃肠感觉运动、营养、喂养技能、儿童行为和心理社会因素共同作用的DGBI表现。文章基于PubMed 可检索的罗马Ⅴ上消化道DGBI正式发表版本、罗马Ⅳ对标文献以及近年英文指南和研究，系统梳理FPFDs 的诊断框架、临床评估与多学科管理策略，以期为临床提供可追溯、易操作的诊疗参考。

关键词: 功能性喂养困难, 肠- 脑互动障碍, 罗马Ⅴ, 儿童

Abstract: Functional feeding disorders can significantly affect nutritional status，growth and development，and quality of life in children. The Rome V criteria classify functional pediatric feeding disorders（FPFDs）within pediatric upper gastrointestinal disorders of gut-brain interaction（DGBI）and subdivide them into hypersensitive dysphagia，anticipatory restrictive feeding， hunger dysregulation feeding disorder，and medically triggered functional feeding disorder. This classification emphasizes that feeding disorders are not merely behavioral problems，but rather DGBI manifestations of interactions among gastrointestinal sensorimotor function，nutrition，feeding skills，child behavior，and psychosocial context. Based on PubMed-indexed Rome V pediatric upper gastrointestinal DGBI articles，corresponding Rome Ⅳ documents，and recent English-language guidelines and studies，this review summarizes the diagnostic framework，clinical evaluation，and multidisciplinary management strategies for FPFDs，with the aim of providing evidence-based and operational references for diagnosis and therapy in clinical practice.

Key words: functional feeding disorders, disorders of gut-brain interaction, Rome V, children