目的 分析发生早产儿喂养不耐受（Feeding intolerance,FI）的危险因素，为临床工作提供可靠证据。 方法 计算机检索PubMed、Embase、中国生物医学文献数据库、中国知网等8个数据库中关于FI影响因素的队列研究、病例对照研究及横断面研究，检索时限为建库至2022年10月，并采用RevMan 5.2进行Meta分析。 结果 纳入21篇文献，研究对象7244例，合并20个变量。Meta分析结果显示，出生体重（OR=0.99）、胎龄（OR=0.53）、产前使用糖皮质激素（OR=0.13）是FI的保护因素；出生窒息（OR=2.1）、呼吸暂停（OR=3.71）、宫内窘迫（OR=6.18）、宫内感染（OR=2.09）、胎盘异常（OR=3.48）、胃损伤（OR=2.11）、呼吸窘迫综合征（OR=2.21）、呼吸机使用（OR=4.23）、甲基黄嘌呤类药物使用（OR=2.87）、开奶延迟（OR=1.15）、排便延迟（OR=1.04）]、围生期感染（OR=7.83）、败血症（OR=2.04）、低氧血症（OR=6.87）、多胎（OR=1.88）、性别（OR=2.33）为FI的危险因素。 结论 医务人员应尤其重视存在呼吸窘迫综合征、呼吸机使用、开奶延迟等情况的新生儿，针对具体的危险因素制订个性化方案，以减少FI的发生。

Objective To analyze the risk factors of feeding intolerance(FI) in premature infants,and to provide reliable evidence for clinical work. Methods Cohort studies,case-control studies and cross-sectional studies on the influencing factors of FI were searched by computer from 8 databases including PubMed,Embase,SinoMed,and China National Knowledge Network.The retrieval period was from the inceptions to October 2022,and Meta-analysis was performed by RevMan 5.2. Results Finally,21 articles with 7244 subjects were included, involving 20 variables.The results of Meta-analysis showed that birth weight(OR=0.99),gestational age(OR=0.53) and prenatal glucocorticoid use(OR=0.13) were protective factors for FI. Birth asphyxia(OR=2.1),apnea(OR=3.71),intrauterine distress(OR=6.18),intrauterine infection(OR=2.09),placental abnormality(OR=3.48),gastric injury(OR=2.11),respiratory distress syndrome (OR=2.21),ventilator use(OR=4.23),Methylxanthine drug use(OR=2.87),delayed secretion of colostrum(OR=1.15),delayed defecation(OR=1.04)],perinatal infection (OR=7.83),septicemia(OR=2.04),hypoxemia(OR=6.87),multiple births(OR=1.88),and sex(OR=2.33) were risk factors for FI. Conclusions Medical staff should pay special attention to newborns with respiratory distress syndrome,ventilator use,delayed secretion of colostrum,etc.,and develop personalized programs according to specific risk factors to reduce the occurrence of FI.

R473.72

四川省科技计划项目（2021JDRC0161）