Diehl-Jones William L, Askin Debra Fraser
Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
AACN Clin Issues. 2004 Jan-Mar;15(1):83-96. doi: 10.1097/00044067-200401000-00007.
In humans, growth and development continues until early adulthood when bone, muscle, and nervous tissue reaches final stages of maturity. Adequate levels of nutritional intake and utilization are critical to optimize ongoing growth. The goal of nutritional therapy for premature or ill neonates has been to provide sufficient nutrients to allow growth to continue at rates seen in utero. Functional immaturity of the gut in the premature infant makes absorption and utilization of nutritional substrates difficult. Premature infants are at risk for developing necrotizing enterocolitis, a potentially lethal bowel disorder. The etiology of necrotizing enterocolitis is not well understood, and a number of theories of causation have been proposed. Breast milk, the optimal source of nutrition for the neonate, is believed to confer some protection against necrotizing enterocolitis. A number of breast milk components have been credited with antiinflammatory properties. Breast milk is recognized for its benefits, yet for preterm infants breast milk alone does not promote adequate growth. A number of breast milk supplements have been investigated to facilitate growth and development and to prevent necrotizing enterocolitis. This article addresses development of the fetal gastrointestinal system, focusing on the biological mediators for normal function and the role of human breast milk and its additives in optimizing neonatal growth. The possible etiologies of necrotizing enterocolitis are discussed in terms of the relationship between this disease and enteral feeding practices.
在人类中，生长和发育一直持续到成年早期，此时骨骼、肌肉和神经组织达到成熟的最后阶段。充足的营养摄入和利用水平对于优化持续生长至关重要。早产或患病新生儿营养治疗的目标是提供足够的营养，以使生长以在子宫内观察到的速度继续。早产儿肠道功能不成熟，使得营养底物的吸收和利用变得困难。早产儿有患坏死性小肠结肠炎的风险，这是一种潜在致命的肠道疾病。坏死性小肠结肠炎的病因尚未完全了解，并且已经提出了许多病因理论。母乳是新生儿最佳的营养来源，被认为对坏死性小肠结肠炎有一定的保护作用。许多母乳成分被认为具有抗炎特性。母乳因其益处而得到认可，但对于早产儿来说，仅靠母乳并不能促进充分的生长。已经研究了多种母乳补充剂，以促进生长发育并预防坏死性小肠结肠炎。本文论述胎儿胃肠系统的发育，重点关注正常功能的生物介质以及人乳及其添加剂在优化新生儿生长中的作用。坏死性小肠结肠炎的可能病因将根据该疾病与肠内喂养方式之间的关系进行讨论。
