早产儿宫外生长发育迟缓原因剖析及营养摄入现状

Analysis of causes of extrauterine growth restriction in premature infants and the status of nutritional intake

早产儿宫外生长发育迟缓(EUGR)是全球普遍面临的问题。关于EUGR居高不下的原因,早产儿出生胎龄较小、体质量较低、接受医疗操作及检查增加、营养支持中断已有较多研究,但对于摄入能量、各种营养素能力有限及生长曲线标准的更新却少有报道。文献指出,早产儿脂肪摄入量达到推荐量的平均时间约在生后第6天,蛋白质约在生后第4天,碳水化合物在生后1周左右,其他多种维生素及微量元素通常达不到或需经历较长时间方可达到推荐量。在没有充足的能量和营养供给来维持早产儿宫内生长的速率及追赶生长的需求时,EUGR始终未有改善。文章对患儿EUGR及重要营养素(能量、脂肪、蛋白质、维生素、矿物质等)住院期间的摄入量作一综述,为更合理和规范早产儿的营养管理,有效控制EUGR提供依据和建议。

Extrauterine growth restriction（EUGR） in premature infant is a common problem in the world. The reasons for high EUGR rate, such as declining gestational age and birth weight, getting more medical treatment and examination or interruption of nutritional support, had been profoundly studied. However, there are few reports about the limited ability of intakes of energy and various nutrients and the updating of the growth standard curve. Research suggested that the average time taken to reach the recommended fat intake in preterm infants is proximately day 6 after birth, protein day 4 after birth, carbohydrate oneweek after birth. Vitamins and trace elements are usually not able to or take a long time to reach the recommended nutrient intake. Without enough intake of energy and nutrients to maintain the need of intrauterine growth rate and catch-up growth in preterm infants, EUGR cannot be improved. In this paper, the EUGR and the intake of important nutrients, such as energy, fat, protein, vitamins and minerals, etc., during hospitalization were reviewed in hope to achieve more rational and standardized management for preterm infant,and provide more reasonable advise to control EUGR.