早产儿喂养不耐受临床诊疗指南

早产儿喂养不耐受临床诊疗指南
一、本文概述
Overview of this article
随着医疗技术的不断进步和新生儿重症监护的发展，早产儿的存活率显著提高。

然而，早产儿由于其生理发育尚未成熟，常常面临喂养不耐受的问题，这不仅影响了早产儿的生长发育，还可能引发一系列并发症。

因此，制定一份针对早产儿喂养不耐受的临床诊疗指南至关重要。

With the continuous advancement of medical technology and the development of neonatal intensive care, the survival rate of premature infants has significantly improved. However, premature infants often face feeding intolerance due to their immature physiological development, which not only affects their growth and development, but may also lead to a series of complications. Therefore, it is crucial to develop a clinical diagnosis and treatment guideline for feeding intolerance in premature infants.
本文旨在为临床医生提供早产儿喂养不耐受的诊断、评估、治疗
及预防的综合性指导，以帮助提高早产儿喂养不耐受的诊断率、治疗成功率及预后质量。

本文首先介绍了早产儿喂养不耐受的定义、流行病学特征及其临床表现，随后详细阐述了喂养不耐受的诊断方法、评估标准以及治疗方案，最后对预防策略进行了深入探讨。

This article aims to provide comprehensive guidance to clinical doctors on the diagnosis, evaluation, treatment, and prevention of feeding intolerance in premature infants, in order to help improve the diagnostic rate, treatment success rate, and prognosis quality of feeding intolerance in premature infants. This article first introduces the definition, epidemiological characteristics, and clinical manifestations of feeding intolerance in premature infants. Then, it elaborates in detail on the diagnostic methods, evaluation criteria, and treatment plans for feeding intolerance. Finally, it delves into prevention strategies.
通过本文的阐述，我们期望能够帮助临床医生更好地理解和处理早产儿喂养不耐受问题，为早产儿的健康成长提供有力保障。

我们也期待通过不断的研究和实践，不断完善和优化早产儿喂养不耐受的临床诊疗指南，为早产儿的医疗护理贡献更多的智慧和力量。

Through the explanation in this article, we hope to help clinical doctors better understand and handle the issue of feeding intolerance in premature infants, and provide strong support for the healthy growth of premature infants. We also look forward to continuously improving and optimizing the clinical diagnosis and treatment guidelines for feeding intolerance in premature infants through continuous research and practice, and contributing more wisdom and strength to the medical care of premature infants.
二、早产儿喂养不耐受的定义与诊断
Definition and diagnosis of feeding intolerance in premature infants
早产儿喂养不耐受是指早产儿在喂养过程中出现的一系列临床
表现，包括喂养后呕吐、腹胀、胃潴留等，这些症状通常会导致早产儿生长发育迟缓、营养摄入不足和喂养困难。

早产儿喂养不耐受不仅影响早产儿的生长发育，还可能增加其并发症的风险，如坏死性小肠结肠炎等。

Feeding intolerance of preterm infants refers to a series
of clinical manifestations of preterm infants during the feeding process, including vomiting, abdominal distention, stomach retention, etc. after feeding, these symptoms usually lead to growth retardation, insufficient nutrition intake and feeding difficulties of preterm infants. Feeding intolerance in premature infants not only affects their growth and development, but may also increase the risk of complications such as necrotizing enterocolitis.
定义：早产儿喂养不耐受通常是指在喂养过程中，早产儿出现不能耐受正常喂养量或喂养速度的情况，表现为呕吐、腹胀、胃潴留等症状。

这些症状可能是由于早产儿胃肠道发育不成熟、胃肠道功能紊乱、胃肠道动力异常等原因引起的。

Definition: Feeding intolerance of preterm infants usually refers to the condition that preterm infants cannot tolerate the normal feeding amount or feeding speed during the feeding process, which is manifested by vomiting, abdominal distention, stomach retention and other symptoms. These symptoms may be caused by immature gastrointestinal development, gastrointestinal dysfunction, and abnormal gastrointestinal
motility in premature infants.
诊断：早产儿喂养不耐受的诊断主要依据临床表现和辅助检查。

临床表现包括喂养后呕吐、腹胀、胃潴留等。

辅助检查方面，可以通过腹部超声检查、线检查等手段观察早产儿胃肠道情况，了解是否存在胃肠道发育异常或梗阻等情况。

还可以通过监测早产儿生长发育情况，如体重增长、身高增长等指标，来评估喂养不耐受对早产儿生长发育的影响。

Diagnosis: The diagnosis of feeding intolerance in premature infants is mainly based on clinical manifestations and auxiliary examinations. The clinical manifestations include vomiting, abdominal distention and gastric retention after feeding. In terms of auxiliary examinations, abdominal ultrasound examination, X-ray examination and other methods can be used to observe the gastrointestinal condition of premature infants, and to understand whether there are any abnormal gastrointestinal development or obstruction. The impact of feeding intolerance on the growth and development of premature infants can also be evaluated by monitoring indicators such as weight gain and height gain.
需要注意的是，早产儿喂养不耐受的诊断应结合临床表现和辅助检查，综合考虑多种因素，避免误诊和漏诊。

对于诊断为喂养不耐受的早产儿，应根据具体情况制定个性化的治疗方案，包括调整喂养量、喂养速度、喂养方式等，以促进早产儿的生长发育和康复。

It should be noted that the diagnosis of feeding intolerance in premature infants should be combined with clinical manifestations and auxiliary examinations, taking into account multiple factors to avoid misdiagnosis and missed diagnosis. For premature infants diagnosed with feeding intolerance, personalized treatment plans should be developed based on specific circumstances, including adjusting feeding amount, feeding speed, feeding method, etc., to promote the growth, development, and recovery of premature infants.
三、早产儿喂养不耐受的原因与病理生理
The causes and pathophysiology of feeding intolerance in premature infants
早产儿喂养不耐受是指早产儿在喂养过程中，出现的一种或多种喂养相关的临床症状，包括呕吐、腹胀、胃潴留等。

其产生原因与病
理生理机制复杂多样，主要涉及以下几个方面。

Feeding intolerance of preterm infants refers to one or more feeding related clinical symptoms of preterm infants during feeding, including vomiting, abdominal distention, stomach retention, etc. The causes and pathophysiological mechanisms of its occurrence are complex and diverse, mainly involving the following aspects.
早产儿在母体内的发育时间较短，其消化系统尚未完全成熟。

例如，早产儿的胃容量小，胃肠蠕动不协调，食管括约肌发育不成熟等，这些因素都可能导致喂养不耐受的发生。

Premature infants have a relatively short developmental time in the mother's body, and their digestive system is not yet fully mature. For example, the small gastric capacity, uncoordinated gastrointestinal peristalsis, and immature development of the esophageal sphincter in premature infants can all lead to the occurrence of feeding intolerance.
早产儿出生时往往伴随着一些疾病或并发症，如新生儿坏死性小肠结肠炎、食管闭锁、幽门狭窄等，这些疾病会直接影响早产儿的喂养耐受性。

Premature infants are often accompanied by some diseases or complications at birth, such as neonatal necrotizing enterocolitis, esophageal atresia, pyloric stenosis, etc. These diseases can directly affect the feeding tolerance of premature infants.
再者，早产儿在出生后可能会面临一些应激情况，如手术、感染、缺氧等，这些应激情况会引起早产儿全身炎症反应，进一步影响喂养耐受性。

Furthermore, premature infants may face some stress situations after birth, such as surgery, infection, hypoxia, etc. These stress situations can cause systemic inflammatory reactions in premature infants, further affecting feeding tolerance.
早产儿在营养支持治疗过程中，如静脉营养、肠内营养等，可能会出现喂养不耐受的情况。

这可能是由于营养物质的种类、浓度、输注速度等不当，导致早产儿胃肠道负担过重，从而引发喂养不耐受。

Premature infants may experience feeding intolerance during nutritional support treatments such as intravenous nutrition and enteral nutrition. This may be due to improper
types, concentrations, infusion rates, and other factors of nutrients, resulting in an excessive burden on the gastrointestinal tract of premature infants and leading to feeding intolerance.
在病理生理方面，早产儿喂养不耐受的发生与胃肠道动力障碍、肠道微生态失衡、肠道免疫功能障碍等因素有关。

这些因素相互作用，共同导致早产儿喂养不耐受的发生。

In terms of pathophysiology, the occurrence of feeding intolerance in premature infants is related to factors such as gastrointestinal motility disorders, imbalance of intestinal microbiota, and intestinal immune dysfunction. These factors interact with each other and together lead to the occurrence of feeding intolerance in premature infants.
因此，对于早产儿喂养不耐受的临床诊疗，需要充分了解其原因与病理生理机制，以便制定出更为科学合理的诊疗方案，提高早产儿的喂养耐受性，促进其健康成长。

Therefore, for the clinical diagnosis and treatment of feeding intolerance in premature infants, it is necessary to fully understand its causes and pathophysiological mechanisms,
in order to develop more scientific and reasonable diagnosis and treatment plans, improve the feeding tolerance of premature infants, and promote their healthy growth.
四、早产儿喂养不耐受的治疗策略
Treatment strategies for feeding intolerance in premature infants
早产儿喂养不耐受是一种常见的临床问题，对早产儿的生长发育产生重要影响。

因此，针对早产儿喂养不耐受的治疗策略显得尤为重要。

以下将详细介绍早产儿喂养不耐受的治疗策略。

Premature feeding intolerance is a common clinical problem that has a significant impact on the growth and development of premature infants. Therefore, treatment strategies for feeding intolerance in premature infants are particularly important. The following will provide a detailed introduction to the treatment strategies for feeding intolerance in premature infants.
非药物治疗：对于喂养不耐受的早产儿，我们可以尝试非药物治疗策略。

这包括调整喂养方式，如减少每次喂养的奶量，增加喂养次
数，或者尝试使用不同的喂养器具，如更细小的奶嘴。

我们还可以尝试给予早产儿体位治疗，如倾斜或竖直抱持，以减少胃食管反流的发生。

Non pharmacological treatment: For premature infants with feeding intolerance, we can try non pharmacological treatment strategies. This includes adjusting the feeding method, such as reducing the amount of milk fed each time, increasing the number of feedings, or trying different feeding devices, such as smaller pacifiers. We can also try to provide positional treatment for premature infants, such as tilting or holding vertically, to reduce the occurrence of gastroesophageal reflux.
药物治疗：如果非药物治疗无效，我们可以考虑使用药物治疗。

常用的药物包括促胃肠动力药，如红霉素，可以促进胃肠蠕动，改善喂养不耐受的症状。

我们还可以使用抑酸药，如质子泵抑制剂，以减少胃酸的产生，从而减轻胃酸对食管黏膜的刺激。

Drug therapy: If non drug therapy is ineffective, we can consider using drug therapy. Commonly used drugs include gastrointestinal motility promoting drugs, such as
erythromycin, which can promote gastrointestinal peristalsis and improve symptoms of feeding intolerance. We can also use acid suppressants, such as proton pump inhibitors, to reduce the production of gastric acid, thereby alleviating the irritation of gastric acid on the esophageal mucosa.
肠内营养支持：对于喂养不耐受严重的早产儿，我们可能需要提供肠内营养支持。

这可以通过鼻胃管或鼻十二指肠管进行，以保证早产儿获得足够的营养。

同时，我们还需要密切监测早产儿的营养状况，以及肠内营养支持可能带来的并发症，如喂养管堵塞或感染等。

Enteral nutrition support: For premature infants with severe feeding intolerance, we may need to provide enteral nutrition support. This can be done through a nasogastric or duodenal tube to ensure that premature infants receive sufficient nutrition. At the same time, we also need to closely monitor the nutritional status of premature infants, as well as the potential complications of enteral nutrition support, such as feeding tube blockage or infection.
外科治疗：在一些特殊情况下，如果早产儿的喂养不耐受症状无法通过上述方法改善，我们可能需要考虑外科治疗。

例如，对于严重
的胃食管反流病，我们可以考虑进行抗反流手术。

然而，需要注意的是，外科治疗应谨慎进行，应在充分评估早产儿的病情和手术风险后进行。

Surgical treatment: In some special cases, if the feeding intolerance symptoms of premature infants cannot be improved through the above methods, we may need to consider surgical treatment. For example, for severe gastroesophageal reflux disease, we can consider undergoing anti reflux surgery. However, it should be noted that surgical treatment should be carried out with caution and after a thorough assessment of the condition and surgical risks of premature infants.
早产儿喂养不耐受的治疗策略应根据早产儿的具体情况进行个
体化选择。

我们还需要密切关注早产儿的营养状况，以及治疗可能带来的副作用和并发症，以确保早产儿能够得到最佳的治疗效果。

The treatment strategy for feeding intolerance in premature infants should be individualized based on their specific conditions. We also need to closely monitor the nutritional status of premature infants, as well as the potential side effects and complications of treatment, to
ensure that premature infants receive the best treatment outcomes.
五、早产儿喂养不耐受的预防与护理
Prevention and nursing of feeding intolerance in premature infants
合理营养支持：在孕期，母亲应保证充足的营养摄入，尤其是蛋白质、维生素和矿物质等，以保证胎儿的正常发育。

Reasonable nutritional support: During pregnancy, mothers should ensure sufficient nutritional intake, especially protein, vitamins, and minerals, to ensure the normal development of the fetus.
优化分娩过程：尽可能减少早产的发生，避免不必要的剖宫产，以减少早产儿喂养不耐受的风险。

Optimize the delivery process: minimize the occurrence of premature birth and avoid unnecessary cesarean section to reduce the risk of feeding intolerance in premature infants.
早期微量喂养：对于早产儿，应尽早开始微量喂养，以刺激胃肠蠕动和胃肠道激素的分泌，促进胃肠道成熟。

Early microfeeding: For premature infants, microfeeding should be started as early as possible to stimulate gastrointestinal peristalsis and secretion of gastrointestinal hormones, promoting gastrointestinal maturation.
喂养方式的选择：根据早产儿的实际情况，选择最适合的喂养方式，如母乳喂养、配方奶喂养或混合喂养。

母乳是首选，因为它含有丰富的营养物质和免疫活性成分，有助于早产儿的生长发育和免疫功能的提高。

Selection of feeding methods: Based on the actual situation of premature infants, choose the most suitable feeding method, such as breastfeeding, formula feeding, or mixed feeding. Breast milk is the first choice because it contains rich nutrients and immune active ingredients, which help the growth and development of premature infants and improve their immune function.
喂养量的调整：喂养量应根据早产儿的体重、生长情况和耐受程度进行调整，避免过量喂养导致喂养不耐受。

Adjustment of feeding amount: The feeding amount should be
adjusted based on the weight, growth status, and tolerance level of premature infants to avoid feeding intolerance caused by overfeeding.
喂养速度的控制：喂养时应控制喂养速度，避免过快或过慢，以减少早产儿出现喂养不耐受的可能性。

Control of feeding speed: During feeding, the feeding speed should be controlled to avoid being too fast or too slow, in order to reduce the possibility of feeding intolerance in premature infants.
体位护理：喂养时应将早产儿置于半卧位或斜卧位，有助于食物的顺利进入胃内，减少反流和呕吐的发生。

Positional care: Premature infants should be placed in a semi recumbent or oblique position during feeding, which helps to facilitate the smooth entry of food into the stomach and reduces the occurrence of reflux and vomiting.
病情观察：密切观察早产儿的喂养情况，包括喂养量、喂养速度、呕吐、腹胀等症状，及时发现并处理喂养不耐受的情况。

Disease observation: closely observe the feeding situation of premature infants, including feeding amount, feeding speed,
vomiting, bloating and other symptoms, and promptly detect and deal with feeding intolerance.
通过合理的预防策略和精心的护理，可以有效地降低早产儿喂养不耐受的发生率，提高早产儿的生存质量。

医护人员和家长应密切合作，共同关注早产儿的喂养问题，为早产儿的健康成长提供有力的保障。

Through reasonable prevention strategies and meticulous care, the incidence of feeding intolerance in premature infants can be effectively reduced, and the quality of life of premature infants can be improved. Medical staff and parents should work closely together to pay attention to the feeding issues of premature infants, providing strong support for their healthy growth.
六、早产儿喂养不耐受的营养支持
Nutritional support for feeding intolerance in premature infants
对于早产儿而言，喂养不耐受可能是一个常见的问题，这不仅影响了他们的生长发育，还可能增加并发症的风险。

因此，为这些特殊
的患儿提供合适的营养支持至关重要。

For premature infants, feeding intolerance may be a common problem, which not only affects their growth and development, but also increases the risk of complications. Therefore, providing appropriate nutritional support for these special children is crucial.
早产儿由于各种原因，如器官发育不成熟、吸吮和吞咽功能不协调等，容易发生喂养不耐受。

长时间的喂养不耐受会导致早产儿营养不良、生长发育迟缓，甚至引发其他并发症。

因此，为早产儿提供及时、合理的营养支持，对于改善他们的健康状况至关重要。

Premature infants are prone to feeding intolerance due to various reasons, such as immature organ development, uncoordinated sucking and swallowing functions, etc. Long term feeding intolerance can lead to malnutrition, delayed growth and development, and even other complications in premature infants. Therefore, providing timely and reasonable nutritional support for premature infants is crucial for improving their health status.
对于早产儿喂养不耐受，应采取综合的营养支持策略，包括调整
喂养方式、增加营养素的摄入以及使用肠内或肠外营养支持等。

For feeding intolerance in premature infants, comprehensive nutritional support strategies should be adopted, including adjusting feeding methods, increasing nutrient intake, and using enteral or parenteral nutritional support.
（1）调整喂养方式：根据早产儿的具体情况，可以尝试调整喂
养频率、喂养量或喂养姿势等，以减少喂养不耐受的发生。

(1) Adjusting feeding methods: Based on the specific situation of premature infants, it is possible to try adjusting feeding frequency, feeding amount, or feeding posture to reduce the occurrence of feeding intolerance.
（2）增加营养素的摄入：在早产儿能耐受的情况下，可以通过
增加母乳或配方奶中的热量、蛋白质和其他关键营养素来满足他们的营养需求。

(2) Increase nutrient intake: When premature infants can tolerate it, their nutritional needs can be met by increasing the calories, proteins, and other key nutrients in breast milk or formula.
（3）肠内营养支持：对于喂养不耐受严重的早产儿，可以考虑
使用肠内营养支持，如使用特殊配方的早产儿奶粉或添加益生菌等，以促进肠道发育和增强免疫力。

(3) Enteral nutrition support: For premature infants with severe feeding intolerance, enteral nutrition support can be considered, such as using special formula premature infant formula or adding probiotics, to promote intestinal development and enhance immunity.
（4）肠外营养支持：对于无法耐受肠内营养的早产儿，可以考虑使用肠外营养支持，即通过静脉输注营养物质来满足他们的生长需求。

(4) Parenteral nutrition support: For premature infants who cannot tolerate enteral nutrition, parenteral nutrition support can be considered, which involves intravenous infusion of nutrients to meet their growth needs.
在实施营养支持的过程中，应密切监测早产儿的生长发育、营养状况和喂养耐受情况，并根据实际情况及时调整营养支持策略，以确保他们获得充足的营养和最佳的生长环境。

In the process of implementing nutritional support, the growth and development, nutritional status, and feeding
tolerance of premature infants should be closely monitored, and nutritional support strategies should be adjusted in a timely manner according to the actual situation to ensure that they receive sufficient nutrition and the best growth environment.
早产儿喂养不耐受的营养支持是一个复杂而重要的问题。

医护人员应根据早产儿的实际情况，制定个性化的营养支持方案，并通过密切的监测和调整，确保他们获得最佳的营养支持。

Nutritional support for feeding intolerance in premature infants is a complex and important issue. Medical staff should develop personalized nutritional support plans based on the actual situation of premature infants, and ensure that they receive the best nutritional support through close monitoring and adjustment.
七、早产儿喂养不耐受的临床观察与随访
Clinical observation and follow-up of feeding intolerance in premature infants
早产儿喂养不耐受是一个需要密切关注和持续管理的临床问题。

因此，对于早产儿喂养不耐受的临床观察与随访至关重要。

Premature infant feeding intolerance is a clinical issue that requires close attention and continuous management. Therefore, clinical observation and follow-up of feeding intolerance in premature infants are crucial.
每次喂养后应仔细观察早产儿有无呕吐、腹胀、胃潴留等喂养不耐受的表现。

After each feeding, the preterm infant should be carefully observed for vomiting, abdominal distention, gastric retention and other feeding intolerance.
注意监测早产儿的体重增长情况，体重增长缓慢或停滞可能是喂养不耐受的一个信号。

Pay attention to monitoring the weight gain of premature infants. Slow or stagnant weight gain may be a signal of feeding intolerance.
观察早产儿的大便情况，包括颜色、形状和频率，以便及时发现肠道问题。

Observe the bowel movements of premature infants, including color, shape, and frequency, in order to detect intestinal problems in a timely manner.
监测早产儿的生命体征，包括体温、心率、呼吸和血氧饱和度，以评估整体状况。

Monitor the vital signs of premature infants, including body temperature, heart rate, respiration, and blood oxygen saturation, to assess overall condition.
制定个性化的随访计划，根据早产儿的实际情况和喂养不耐受的程度调整随访频率。

Develop a personalized follow-up plan and adjust the frequency of follow-up based on the actual situation of premature infants and the degree of feeding intolerance.
每次随访时应详细记录早产儿的喂养情况、生长发育、营养状况等信息。

During each follow-up, detailed information such as feeding status, growth and development, and nutritional status of premature infants should be recorded.
与家长保持密切沟通，提供喂养指导和心理支持，帮助家长建立信心，共同促进早产儿的健康成长。

Maintain close communication with parents, provide feeding guidance and psychological support, help parents build
confidence, and jointly promote the healthy growth of premature infants.
对早产儿喂养不耐受的临床观察与随访需要细致入微，及时发现并处理问题。

通过制定个性化的随访计划和与家长的合作，我们可以为早产儿提供全面的照护和支持，促进他们的健康成长。

The clinical observation and follow-up of feeding intolerance in premature infants need to be meticulous, timely detection and treatment of problems. By developing personalized follow-up plans and collaborating with parents, we can provide comprehensive care and support for premature infants, promoting their healthy growth.
八、结论
Conclusion
早产儿喂养不耐受是一个复杂且需要精细化管理的临床问题。

本指南综合了当前最新的临床研究和实践经验，旨在为早产儿喂养不耐受的诊断和治疗提供全面的指导。

我们强调，对于早产儿喂养不耐受的处理，应以个体化为基础，结合早产儿的生理特点、临床表现和实验室检查，制定针对性的治疗方案。

Premature infant feeding intolerance is a complex clinical problem that requires refined management. This guideline integrates the latest clinical research and practical experience, aiming to provide comprehensive guidance for the diagnosis and treatment of feeding intolerance in premature infants. We emphasize that the management of feeding intolerance in premature infants should be based on individualization, combined with the physiological characteristics, clinical manifestations, and laboratory tests of premature infants, to develop targeted treatment plans.
在诊断方面，我们强调了临床表现、体格检查以及实验室检查的综合运用，以提高诊断的准确性和及时性。

在治疗方面，我们推荐采用多种措施并行的策略，包括优化喂养方式、调整营养配方、使用药物治疗以及必要的支持治疗等。

同时，我们也强调了定期监测和评估的重要性，以便及时调整治疗方案，确保早产儿的健康成长。

In terms of diagnosis, we emphasize the comprehensive application of clinical manifestations, physical examinations, and laboratory tests to improve the accuracy and timeliness of
diagnosis. In terms of treatment, we recommend adopting a parallel strategy of multiple measures, including optimizing feeding methods, adjusting nutritional formulas, using medication therapy, and necessary supportive treatment. At the same time, we also emphasize the importance of regular monitoring and evaluation in order to adjust treatment plans in a timely manner and ensure the healthy growth of premature infants.
本指南的发布旨在为临床医生和护理人员提供一个参考框架，以更好地理解和处理早产儿喂养不耐受的问题。

然而，我们也需要认识到，早产儿喂养不耐受的临床表现和治疗策略可能因个体差异而有所不同。

因此，在应用本指南时，应结合具体情况进行个体化的决策。

The publication of this guide aims to provide a reference framework for clinical doctors and caregivers to better understand and address the issue of feeding intolerance in premature infants. However, we also need to recognize that the clinical manifestations and treatment strategies of feeding intolerance in premature infants may vary depending on individual differences. Therefore, when applying this
guideline, individualized decisions should be made based on specific circumstances.
我们希望通过本指南的推广和应用，能够进一步提高早产儿喂养不耐受的诊断和治疗水平，为早产儿的健康成长提供更好的保障。

我们也期待未来有更多的研究和实践经验能够不断丰富和完善本指南
的内容，为临床医生和护理人员提供更多的参考和支持。

We hope that through the promotion and application of this guideline, the diagnosis and treatment level of feeding intolerance in premature infants can be further improved, providing better protection for the healthy growth of premature infants. We also look forward to more research and practical experience in the future to continuously enrich and improve the content of this guideline, providing more references and support for clinical doctors and nursing staff.。