欧洲家庭肠外营养（HPN）患者的监测：一项基于问卷调查的42个中心监测实践研究

Monitoring of patients on home parenteral nutrition (HPN) in Europe: a questionnaire based study on monitoring practice in 42 centres.

作者信息

Wengler Anne, Micklewright Ann, Hébuterne Xavier, Bozzetti Federico, Pertkiewicz Marek, Moreno Jose, Pironi Loris, Thul Paul, Van Gossum Andre, Staun Michael

机构信息

Department of Medical Gastroenterology, Rigshospitalet, Copenhagen, Denmark.

出版信息

Clin Nutr. 2006 Aug;25(4):693-700. doi: 10.1016/j.clnu.2006.01.026. Epub 2006 May 15.

DOI:10.1016/j.clnu.2006.01.026

PMID:16698149

Abstract

INTRODUCTION & AIM: To gather information about how adult patients on home parenteral nutrition (HPN) are monitored after discharge from the hospital.

METHOD

A questionnaire about HPN monitoring practice was circulated to HPN centres in eight European countries through the representative of the ESPEN HAN-working group. Centres were asked about guidelines, home visits and how monitoring and handling of complications were managed.

RESULTS

Fourty-two centres in eight European countries completed the questionnaire: UK n=14, France n=9, Belgium n=4, Italy n=4, Poland n=4, Denmark n=4, Spain n=2, Germany n=1. The HPN experience of the centres was in the range 2-30 years. Centres ranged in size from 0 to 125 HPN patients representing a total number of 934 of whom 54% had received HPN for more than 2 years. The primary disease was non-malignant in 90% whilst 10% had been diagnosed with active cancer. Of the centres 92% had a HPN team and 66% had written guidelines for monitoring HPN. Home visits after discharge for monitoring purposes were carried out by 31 of the centres involving the HPN team, general practitioner, community nurse or home care agency. Stable patients on HPN for more than 12 months were monitored at the discharging hospital (73%), at a local hospital (12%), by the General Practitioner (11%) or by a home care agency (4%). Of the centres, 90% reported that the main responsibility for monitoring was assigned to a specific person. The intervals between monitoring visits for the stable HPN patient was in the range 1-6 months, 52% of the centres reported intervals of 2-3 months. In case of complications 76% of centres reported that patients got in touch with the HPN team, 2% the local hospital, 5% the home care agency, and 17% other. Re-admission to hospital was usually to the HPN centre and only occasionally to a local hospital.

CONCLUSION

In Europe a specialised team at the discharging hospital monitors HPN patients and 66% of the centres had some kind of written guidelines.

摘要

引言与目的

收集关于成人家庭肠内营养（HPN）患者出院后如何进行监测的信息。

方法

通过欧洲临床营养与代谢学会（ESPEN）家庭肠内营养工作组的代表，向八个欧洲国家的HPN中心发放了一份关于HPN监测实践的调查问卷。询问各中心关于指南、家访以及并发症的监测与处理方式。

结果

八个欧洲国家的42个中心完成了调查问卷：英国14个，法国9个，比利时4个，意大利4个，波兰4个，丹麦4个，西班牙2个，德国1个。各中心的HPN经验在2至30年之间。中心规模从0至125名HPN患者不等，总数为934名，其中54%接受HPN治疗超过2年。90%的原发性疾病为非恶性，10%被诊断为活动性癌症。92%的中心有HPN团队，66%有HPN监测的书面指南。31个中心为监测目的在出院后进行家访，涉及HPN团队、全科医生、社区护士或家庭护理机构。接受HPN治疗超过12个月的稳定患者在出院医院接受监测（73%），在当地医院（12%），由全科医生（11%）或家庭护理机构（4%）。90%的中心报告称监测主要责任由特定人员承担。稳定的HPN患者监测访视间隔在1至6个月之间，52%的中心报告间隔为2至3个月。出现并发症时，76%的中心报告患者会联系HPN团队，2%联系当地医院，5%联系家庭护理机构，17%联系其他方面。再次入院通常是回到HPN中心，只有偶尔会去当地医院。