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[癌症患者家庭治疗的全胃肠外营养]

[Total parenteral nutrition for home therapy in cancer patients].

作者信息

Shirotani N, Yoneyama K, Hamano K

机构信息

2nd Dept. of Surgery, Tokyo Women's Medical College, Japan.

出版信息

Gan To Kagaku Ryoho. 1991 Dec;18(15):2523-8.

PMID:1746968
Abstract

Home parenteral nutrition (HPN) was used in 14 cancer patients within a 4-yr and 4-month period. Indications included severe malabsorption, short bowel syndrome, radiation enteritis, and malignancies. The mean duration of HPN was 184 days (range: 21-706 days). HPN duration for patients with benign causes (BP) was longer [427 days (range: 176-706 days)] than for cancer-related patients (CP) [49 days (range: 21-121 days)]. The mean catheter life spans to date for BP and CP have been 596 days (range: 187-1173 days) and 127 days (range: 73-278 days), respectively. Serious catheter problems occurred 4 times in BP with the external catheter. Metabolic complications with clinical symptoms occurred in one BP who had short bowel syndrome. We followed with an evaluation of the quality of life of HPN patients. Three in 14 cases returned to work, two of them part time, and two others did most of the housekeeping, but 9 remained at home receiving only outpatient treatment. Some physical distress was recorded in all but one case. We concluded that HPN for cancer patients is a relatively safe, effective means of improving and maintaining the nutritional status, and it can reduce the length of hospitalization. We attempted to evaluate whether these patients were able to achieve a meaningful and satisfactory social and familial life. Our study was not sufficient to assess the psychological and social problems. We should establish criteria for quality of life to evaluate overall satisfaction with conditions of life under HPN.

摘要

在4年零4个月的时间里,14例癌症患者接受了家庭肠外营养(HPN)治疗。适应证包括严重吸收不良、短肠综合征、放射性肠炎和恶性肿瘤。HPN的平均持续时间为184天(范围:21 - 706天)。良性病因(BP)患者的HPN持续时间[427天(范围:176 - 706天)]比癌症相关患者(CP)[49天(范围:21 - 121天)]更长。迄今为止,BP和CP患者的导管平均使用寿命分别为596天(范围:187 - 1173天)和127天(范围:73 - 278天)。BP患者的外置导管出现严重导管问题4次。1例患有短肠综合征的BP患者出现了伴有临床症状的代谢并发症。我们对HPN患者的生活质量进行了评估。14例患者中有3例恢复工作,其中2例为兼职,另外2例承担了大部分家务,但9例仍在家中仅接受门诊治疗。除1例患者外,其他所有患者均记录有一定身体不适。我们得出结论,癌症患者的HPN是改善和维持营养状况的一种相对安全、有效的方法,并且可以缩短住院时间。我们试图评估这些患者是否能够实现有意义且令人满意的社会和家庭生活。我们的研究不足以评估心理和社会问题。我们应该建立生活质量标准,以评估对HPN下生活状况的总体满意度。

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