Department of Neonatology, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Nutr Rev. 2014 Aug;72(8):532-40. doi: 10.1111/nure.12110. Epub 2014 Jun 17.
Recent advances in perinatal and neonatal intensive care have resulted in significant improvements in the survival of preterm extremely low-birthweight (PELBW) infants; however, extrauterine growth restriction (EUGR) and undernutrition occur frequently during hospitalization and are associated with adverse outcomes, including bronchopulmonary dysplasia, sepsis, and neurodevelopmental impairment. Early optimal parenteral nutrition with adequate amino acids and lipids, especially long-chain polyunsaturated fatty acids, has been shown to decrease the incidence of EUGR, bronchopulmonary dysplasia, necrotizing enterocolitis, sepsis, and retinopathy of prematurity in animal models and clinical trials. In PELBW infants, breast milk and probiotics have been shown to reduce the incidence of necrotizing enterocolitis, and lactoferrin has been demonstrated to prevent late-onset sepsis. Thus, early administration of optimal postnatal parenteral and enteral nutrients can help prevent neurodevelopmental impairment caused by EUGR, necrotizing enterocolitis, sepsis, bronchopulmonary dysplasia, and retinopathy of prematurity, and recent evidence indicates such treatment is feasible.
近年来，围产期和新生儿重症监护的进步显著提高了极早产儿（PELBW）的存活率；然而，宫外生长受限（EUGR）和营养不足在住院期间经常发生，并与不良结局相关，包括支气管肺发育不良、败血症和神经发育障碍。早期给予足够的氨基酸和脂质（尤其是长链多不饱和脂肪酸）的肠外营养已被证明可降低动物模型和临床试验中 EUGR、支气管肺发育不良、坏死性小肠结肠炎、败血症和早产儿视网膜病变的发生率。在 PELBW 婴儿中，母乳和益生菌已被证明可降低坏死性小肠结肠炎的发生率，乳铁蛋白已被证明可预防晚发性败血症。因此，早期给予最佳的产后肠外和肠内营养可以帮助预防由 EUGR、坏死性小肠结肠炎、败血症、支气管肺发育不良和早产儿视网膜病变引起的神经发育障碍，最近的证据表明这种治疗是可行的。
