Puntis J W L
Department of Paediatrics, Room 142, B Floor, The General Infirmary at Leeds, Belmont Grove, Leeds LS2 9NS, UK.
Postgrad Med J. 2006 Mar;82(965):192-8. doi: 10.1136/pgmj.2005.038109.
The theory and practice of nutritional support in the premature newborn has assumed increasing importance with survival of greater numbers of very immature infants. After birth, many do not tolerate full enteral feeding until gastrointestinal motor function has matured. During this process some will develop necrotising enterocolitis (NEC), a devastating failure of adaptation to postnatal life that may result in death, or severe complications. The feeding strategy that minimises the risk of NEC remains to be defined. In addition, promoting growth rates and nutrient accretion equivalent to those achieved during fetal development while optimising neurodevelopmental and long term health outcomes represents an important challenge for neonatologists. This review will focus on the problems associated with enteral nutrition, the requirement for parenteral nutrition, and the long term consequences of early nutritional interventions, underlining the need for prolonged follow up in assessing the potential benefits of different approaches to feeding.
随着越来越多极不成熟婴儿的存活，早产新生儿营养支持的理论与实践变得越发重要。出生后，许多婴儿在胃肠运动功能成熟之前无法耐受完全经口喂养。在此过程中，一些婴儿会发生坏死性小肠结肠炎（NEC），这是一种适应出生后生活的灾难性失败，可能导致死亡或严重并发症。将NEC风险降至最低的喂养策略仍有待确定。此外，在优化神经发育和长期健康结果的同时，促进与胎儿发育期间相当的生长速度和营养积累，对新生儿科医生来说是一项重大挑战。本综述将聚焦于与肠内营养相关的问题、肠外营养的需求以及早期营养干预的长期后果，强调在评估不同喂养方法的潜在益处时需要长期随访。
