目的 探讨出院后强化母乳喂养对中高危营养风险早产儿生长发育、常见合并症及神经心理发育的影响。 方法 回顾性收集2021年1月—2023年12月山东第一医科大学附属省立医院新生儿科出院并完成6个月随访的320例中高危营养风险早产儿的临床资料。根据出院时营养风险等级及喂养方式分为中危-强化母乳、中危-配方奶、高危-强化母乳、高危-配方奶4组。比较同一风险分级下强化母乳组和配方奶组，以及同一喂养方式下中危组和高危组在生长发育、常见合并症及神经心理发育方面的差异。 结果 同一喂养方式下，中危组与高危组的出生胎龄和出生体重差异有统计学意义（P<0.001）；同一营养风险分级下，强化母乳组与配方奶组的出生胎龄和出生体重的差异无统计学意义（P>0.05）。强化母乳喂养的中危与高危组患儿出院时校正胎龄差异有统计学意义（P<0.05）；4组间出院时体重、身长、头围的差异均无统计学意义（P>0.05）。协方差分析显示，在平衡了出院时体重、身长、头围及校正胎龄的影响后，随访6个月期间，4组间体重、身长、头围增长速度，以及第1、3、5个月血红蛋白、25‑羟维生素D、碱性磷酸酶等生化指标的差异均无统计学意义（P>0.05）。多因素logistic回归分析显示，强化母乳喂养并不增加感染（OR=0.66，95%CI：0.40~1.08，P=0.097）和喂养不耐受（OR=0.70，95%CI：0.45~1.08，P=0.107）的发生风险。4组患儿校正6月龄时智力、运动、行为评分差异均无统计学意义（P>0.05）。 结论 在中高危营养风险早产儿中，出院后强化母乳喂养不增加感染和喂养不耐受的发生风险，与配方奶喂养患儿在短期追赶生长及神经心理发育方面无显著差异，具有一定的临床可行性和安全性。

Objective To investigate the effects of post-discharge fortified human milk feeding on growth, common complications, and neuropsychological development in preterm infants with moderate-to-high nutritional risk. Methods Clinical data were retrospectively collected from 320 preterm infants with moderate-to-high nutritional risk who were discharged from the Department of Neonatology, Provincial Hospital Affiliated to Shandong First Medical University between January 2021 and December 2023 and completed a 6-month follow-up. Infants were classified into four groups by nutritional risk level and feeding method: moderate-risk fortified human milk, moderate-risk formula, high-risk fortified human milk, and high-risk formula. Comparisons were conducted between fortified human milk and formula within the same risk level, and between moderate- and high-risk groups within the same feeding method. Results Within the same feeding method, gestational age at birth and birth weight differed significantly between moderate- and high-risk infants (P<0.001). Within the same nutritional risk level, no significant differences were found between fortified human milk and formula groups in gestational age at birth and birth weight (P>0.05). In the fortified human milk groups, corrected gestational age at discharge differed significantly between moderate- and high-risk infants (P<0.05). No significant differences were noted among the four groups in discharge weight, length, or head circumference (P>0.05). Analysis of covariance, adjusting for discharge weight, length, head circumference, and corrected gestational age at discharge, showed no significant differences among the four groups during the 6-month follow-up in growth velocities of weight, length, or head circumference, nor in hemoglobin, 25-hydroxyvitamin D, or alkaline phosphatase measured at 1, 3, and 5 months (P>0.05). Multivariable logistic regression indicated that fortified human milk feeding did not increase the risk of infection (OR=0.66, 95%CI: 0.40-1.08, P=0.097) or feeding intolerance (OR=0.70, 95%CI: 0.45-1.08, P=0.107). At 6 months' corrected age, mental, motor, and behavioral scores did not differ significantly among groups (P>0.05). Conclusions In preterm infants at moderate-to-high nutritional risk, post-discharge fortified human milk feeding does not increase the risk of infection or feeding intolerance, does not differ significantly from formula feeding in short-term catch-up growth or neuropsychological development, and appears clinically feasible and safe.