Hebuterne X, Bozzetti F, Moreno Villares J M, Pertkiewicz M, Shaffer J, Staun M, Thul P, Van Gossum A
Department of Gastroenterology and Nutrition, Hôpital de l'Archet, Nice, France
Clin Nutr. 2003 Jun;22(3):261-6. doi: 10.1016/s0261-5614(03)00005-0.
This study was undertaken to report indications and practice of home enteral nutrition (HEN) in Europe.
A questionnaire on HEN practice was sent to 23 centres from Belgium (B), Denmark (D), France (F), Germany (G), Italy (I), Poland (P), Spain (S) and the United Kingdom (UK). This involved adult patients newly registered in HEN programme from 1 January 1998 to 31 December 1998.
A total of 1397 patients (532 women, 865 men) were registered. The median incidence of HEN was 163 patients/million inhabitants/year (range: 62-457). Age distribution was 7.5%, 16-40 years; 37.1%, 41-65 years; 34.5%, 66-80 years and 20.9% >80 years. The chief underlying diseases were a neurological disorder (49.1%), or head and neck cancer (26.5%); the main reason for HEN was dysphagia (84.6%). A percutaneous endoscopic gastrostomy (58.2%) or a naso-gastric tube (29.3%) were used to infuse commercial standard or high energy diets (65.3%), or fibre diets (24.5%); infusion was cyclical (61.5%) or bolus (34.1%). Indications and feeds were quite similar throughout the different centres but some differences exist concerning the underlying disease. There was greater variation in the choice of tubes and mode of infusion. In F, G, I, S, and UK, costs of HEN are fully funded. In B, D, and P patients have to pay part or all of the charges.
In Europe, HEN was utilised mainly in dysphagic patients with neurological disorders or cancer, using a standard feed via a PEG. However, there were important differences among the countries in the underlying diseases treated, the routes used, the mode of administration and the funding.
本研究旨在报告欧洲家庭肠内营养（HEN）的适应证及应用情况。
向来自比利时（B）、丹麦（D）、法国（F）、德国（G）、意大利（I）、波兰（P）、西班牙（S）和英国（UK）的23个中心发送了一份关于HEN应用情况的调查问卷。调查对象为1998年1月1日至1998年12月31日新登记进入HEN项目的成年患者。
共登记了1397例患者（532例女性，865例男性）。HEN的中位发病率为每年每百万居民163例患者（范围：62 - 457例）。年龄分布为：7.5%，16 - 40岁；37.1%，41 - 65岁；34.5%，66 - 80岁；20.9%大于80岁。主要基础疾病为神经系统疾病（49.1%）或头颈癌（26.5%）；HEN的主要原因是吞咽困难（84.6%）。采用经皮内镜下胃造口术（58.2%）或鼻胃管（29.3%）输注商业标准或高能量饮食（65.3%）或纤维饮食（24.5%）；输注方式为周期性（61.5%）或推注（34.1%）。不同中心的适应证和喂养方式相当相似，但基础疾病存在一些差异。在管道选择和输注方式上存在较大差异。在法国、德国、意大利、西班牙和英国，HEN的费用全部由医保支付。在比利时、丹麦和波兰，患者必须支付部分或全部费用。
在欧洲，HEN主要用于患有神经系统疾病或癌症的吞咽困难患者，通过经皮内镜下胃造口术使用标准喂养方式。然而，各国在治疗的基础疾病、使用的途径、给药方式和资金方面存在重要差异。
