目的 评估功能性超声在早产儿喂养不耐受（feeding intolerance, FI）早期预警中的临床应用价值。 方法 对107例（FI组48例，非FI组59例）早产儿进行前瞻性队列研究。采用功能性超声评估胃排空时间、肠道蠕动频率及管腔内气液异常情况。 结果 FI组胃排空时间显著延长［（46±8）min vs（36±7）min，P<0.001］，肠蠕动频率降低［（8.8±2.0）次/5 min vs（12.4±3.3）次/5 min，P<0.001］，肠腔中度及以上气液异常率显著增加（63% vs 20%，P<0.001）。联合胃排空时间、肠道蠕动频率及肠腔气液界面评分3个功能性超声参数构建的多变量logistic回归预测FI模型的受试者操作特征曲线下面积（area under the curve, AUC）达0.910（灵敏度79.2%，特异度93.2%）。内部验证（AUC=0.911，95%CI：0.845~0.964）和外部验证（AUC=0.904，95%CI：0.854~1.000）均显示该模型具有较高的预测能力。亚组分析显示，该模型在不同胎龄与出生体重组中仍保持良好的预测能力。 结论 功能性超声能在FI临床表现出现前识别肠道功能异常，具备明确的早期预警价值，联合参数模型可用于早产儿喂养风险评估与个体化管理，具有较高的临床实用性与推广潜力。

Objective To evaluate the clinical value of functional ultrasound for early warning of feeding intolerance (FI) in preterm infants. Methods A prospective cohort analysis was performed in 107 preterm infants (FI group, n=48; non-FI group, n=59). Functional ultrasound was used to assess gastric emptying time, intestinal peristalsis frequency, and intraluminal gas-liquid abnormalities. Results Compared with the non-FI group, the FI group had a significantly prolonged gastric emptying time [(46±8) min vs (36±7) min, P<0.001], a reduced intestinal peristalsis frequency [(8.8±2.0) times/5 min vs (12.4±3.3) times/5 min, P<0.001], and a higher rate of moderate or greater gas-liquid abnormalities (63% vs 20%, P<0.001). A multivariable logistic regression model based on three functional ultrasound parameters—gastric emptying time, intestinal peristalsis frequency, and intestinal gas-liquid interface score—achieved an area under the receiver operating characteristic curve (AUC) of 0.910 (sensitivity 79.2% and specificity 93.2%). Internal validation (AUC=0.911, 95%CI: 0.845-0.964) and external validation (AUC=0.904, 95%CI: 0.854-1.000) both showed high predictive performance. Subgroup analyses indicated that the model retained good predictive ability across gestational age and birth weight groups. Conclusions Functional ultrasound can detect intestinal dysfunction before clinical manifestations of FI. The combined parameter model can be used for FI risk assessment and individualized feeding management in preterm infants, with high clinical applicability and potential for broader implementation.