Duerksen Donald R, Ting Ellen, Thomson Patti, McCurdy Kerri, Linscer Joanna, Larsen-Celhar Sheri, Brennenstuhl Elaine
Manitoba Home Nutrition Program, Winnipeg, Canada.
Nutrition. 2004 Sep;20(9):760-3. doi: 10.1016/j.nut.2004.05.010.
There is controversy regarding the use of total parenteral nutrition (TPN) in individuals with metastatic malignancies. The objective of this study was to determine whether a subgroup of patients with intestinal obstruction would benefit from support with TPN.
A retrospective review of patients considered for home TPN by a regionalized home TPN program was conducted
Over a 6-y period, nine patients with primary gastrointestinal malignancy and metastatic intestinal obstruction were identified. There was a variable survival rate of 27 to 433 d. Survival rate longer than 60 d was noted in six of nine patients. Most patients had no direct TPN-related complications, but one patient had significant morbidity related to venous thrombosis and line sepsis. There were no nutritional predictors of prolonged survival rate with TPN. TPN was continued until death in six of nine patients.
Patients with small bowel obstruction and metastatic malignancy may benefit from TPN as demonstrated by prolonged survival rate longer than 60 d. There are no clear predictors of who will benefit from TPN, and each case should be considered individually, with the potential risks and benefits discussed with the family and primary caregivers. Future studies should address the effect of TPN on quality of life of the patient and their caregivers.
对于转移性恶性肿瘤患者使用全胃肠外营养（TPN）存在争议。本研究的目的是确定肠梗阻患者亚组是否能从TPN支持中获益。
对一个区域化家庭TPN项目考虑给予家庭TPN的患者进行回顾性研究。
在6年期间，确定了9例原发性胃肠道恶性肿瘤合并转移性肠梗阻患者。生存时间为27至433天不等。9例患者中有6例生存时间超过60天。大多数患者没有直接与TPN相关的并发症，但有1例患者出现与静脉血栓形成和导管败血症相关的严重发病情况。没有TPN延长生存率的营养预测指标。9例患者中有6例持续接受TPN直至死亡。
小肠梗阻合并转移性恶性肿瘤患者可能从TPN中获益，表现为生存时间超过60天。目前尚无明确的指标提示哪些患者能从TPN中获益，每例患者都应单独评估，并与家属和主要照护者讨论潜在的风险和益处。未来的研究应关注TPN对患者及其照护者生活质量的影响。
