早产儿营养的最优化

发布时间：2018-01-24 14:40

本文关键词： 静脉营养胃肠外营养肠内营养氨基酸葡萄糖脂肪坏死性小肠结肠炎早产儿　出处：《中国当代儿科杂志》2017年01期 　论文类型：期刊论文

【摘要】：早产儿营养补给的目标是使早产儿能够达到同胎龄健康胎儿的正常生长速率,并且在器官生长、组织成分、以及细胞数量和结构方面也能达到健康胎儿水平。营养物质的数量与质量对于早产儿的正常生长发育、包括神经系统发育是至关重要的。基本营养素的供给不足不仅会造成生长受限,而且会增加病死率或影响神经发育结局。早产儿在NICU住院期间的生长速率在神经发育及整个人体发育的结局中发挥了重要作用。尽管对于最佳营养的需求非常明显,但早产儿生长落后的例子比比皆是。因此,根据总的能量及蛋白质需求以及个体成分如氨基酸、碳水化合物及脂肪,甚至细化到氧气的需求来优化早产儿的营养是非常必要的。该综述阐述了早产儿科学合理的营养需求、具有实用性的营养指南以及早产儿静脉营养、肠内营养的方法步骤。包括氨基酸在内的静脉营养,应该从一出生便按照相应胎龄所适合的速率开始补充。肠内营养则应在出生后尽早开始,首选母亲的初乳和牛奶。肠内营养应根据热能需要开始建立并在能耐受的范围内快速增加,保持营养摄入在推荐速率的同时相应地减少静脉营养摄入量。制定一个合理的喂养方案对于改善营养状况及相关的转归是重要的。什么是早产儿的最佳营养和生长速率尚有待于进一步的研究来确定,这种最佳营养不仅能使早产儿神经认知得到最充分的发育,同时还要最大程度地限制其远期发生慢性疾病的风险。
[Abstract]:The goal of nutritional supplements for preterm infants is to enable premature infants to achieve the normal growth rate of healthy fetuses of the same gestational age, and to grow in organs, tissue components. And the number and structure of cells can also reach the level of healthy fetus. The quantity and quality of nutrients for the normal growth and development of premature infants. Including the development of the nervous system is crucial. Inadequate supply of basic nutrients can not only cause growth constraints. The growth rate of premature infants during NICU hospitalization plays an important role in neurodevelopment and the outcome of human development as a whole, despite the need for optimal nutrition. Very obvious. But there are plenty of cases of premature undergrowth. Therefore, based on total energy and protein requirements and individual components such as amino acids, carbohydrates and fats. It is necessary to refine the oxygen requirement to optimize the nutrition of premature infants. This review describes the scientific and reasonable nutritional requirements of premature infants, practical nutrition guidelines and intravenous nutrition of premature infants. Parenteral nutrition. Parenteral nutrition, including amino acids, should be replenished at a rate appropriate to the gestational age at birth, and enteral nutrition should begin as early as possible after birth. First choice for mother's colostrum and milk. Enteral nutrition should be established in accordance with thermal energy needs and be rapidly increased within the tolerance range. Maintain nutritional intake at a recommended rate and reduce intravenous intake accordingly. It is important to develop a reasonable feeding plan to improve nutritional status and related outcomes. What is the best nutrition and birth of premature infants. The long rate remains to be determined by further study. This optimal nutrition not only maximizes neurocognitive development in preterm infants, but also maximizes the risk of long-term chronic disease.
【作者单位】： Perinatal
【正文快照】： Introduction The goal of nutrition of the preterm infant is to meet the growth rate of the healthy fetus of the same gestational age[1].It also is important to produce the same body composition of the healthy fetus in terms of organ growth,tissue compon

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