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合并常见疾病的早产儿的营养管理:一项叙述性综述

Nutritional Management for Preterm Infants with Common Comorbidities: A Narrative Review.

作者信息

Chen Cheng-Yen, Lai Mei-Yin, Lee Cheng-Han, Chiang Ming-Chou

机构信息

Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 33305, Taiwan.

Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan.

出版信息

Nutrients. 2025 Jun 9;17(12):1959. doi: 10.3390/nu17121959.

Abstract

The complications observed in preterm infants are largely attributable to underdeveloped organ systems and inadequate nutritional stores at birth. Insufficient nutritional support can further exacerbate persistent sequelae, such as bronchopulmonary dysplasia (BPD), metabolic bone disease of prematurity (MBDP), and retinopathy of prematurity (ROP). As a result, clinicians have collaborated to develop optimal nutrition strategies for preterm neonates. However, these clinical nutrition plans may be hindered by several factors, including fluid restrictions due to patent ductus arteriosus (PDA) and delayed enteral nutrition following necrotizing enterocolitis (NEC). Modified strategies for specific conditions can help prevent further deterioration, but inadequate nutritional support may limit organ growth and contribute to additional complications. Achieving an optimal balance between nutritional support and managing specific medical conditions varies across institutions. In addition to fluid balance and energy intake, supplementary nutrition-such as vitamins and probiotics-plays a crucial role in disease prevention. Drawing on recent evidence and our clinical experiences with neonatal nutritional strategies, this review article summarizes the specialized nutritional management required for preterm neonates with conditions such as BPD, NEC, MBDP, PDA, and ROP.

摘要

早产儿出现的并发症很大程度上归因于出生时器官系统发育不全和营养储备不足。营养支持不足会进一步加重持续性后遗症,如支气管肺发育不良(BPD)、早产儿代谢性骨病(MBDP)和早产儿视网膜病变(ROP)。因此,临床医生共同制定了针对早产新生儿的最佳营养策略。然而,这些临床营养计划可能会受到多种因素的阻碍,包括动脉导管未闭(PDA)导致的液体限制以及坏死性小肠结肠炎(NEC)后的肠内营养延迟。针对特定情况的改良策略有助于防止病情进一步恶化,但营养支持不足可能会限制器官生长并导致更多并发症。在不同机构中,实现营养支持与管理特定医疗状况之间的最佳平衡各不相同。除了液体平衡和能量摄入外,补充营养物质(如维生素和益生菌)在疾病预防中起着至关重要的作用。基于最近的证据以及我们在新生儿营养策略方面的临床经验,本文综述总结了患有BPD、NEC、MBDP、PDA和ROP等疾病的早产新生儿所需的特殊营养管理方法。

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