Stokes M A, Irving M H
Department of Surgery, University of Manchester School of Medicine, Hope Hospital, Salford, United Kingdom.
Dis Colon Rectum. 1988 Jun;31(6):454-8. doi: 10.1007/BF02552616.
The United Kingdom and Ireland Register of Home Parenteral Nutrition (HPN) contains details on 237 cases treated between 1977 and 1987. One hundred courses of HPN were given to 89 patients for complications of Crohn's disease. Six registering centers provided 87 percent of the courses of treatment. The short-bowel syndrome was a factor in 60 patients, fistulas in 29 patients, and exacerbation of the disease in 41 patients. Thirty patients had more than one complication. The age distribution of patients with Crohn's disease was the same as for all HPN patients. Nine patients have died and eight have ceased HPN because of complications from the treatment. Fifty two percent of the patients had no complications. Patients with Crohn's disease on HPN had a significantly better lifestyle than the group as a whole (P less than .05) and had lower sepsis and complication rates (P less than .01 and 0.001, respectively). The 60 Crohn's patients with short-bowel syndrome spent a significantly longer time on HPN than Crohn's patients overall (P less than .05). Only 15 of these have been able to cease treatment and resume enteral feeding, compared with 23 of the other 40 patients who were able to resume enteral nutrition after a median of three months. Analysis of the authors' group of 35 patients included in the 100 showed that the only nutritional parameters of use in monitoring the patients' well-being were weight and serum albumin. Eighty percent of the patients with Crohn's disease who were treated by HPN have either successfully resumed enteral feeding or are successfully managing their own HPN. HPN is a safe and effective treatment for patients with acute or chronic intestinal failure from Crohn's disease.
英国和爱尔兰家庭肠内营养（HPN）登记册包含了1977年至1987年间接受治疗的237例病例的详细信息。89名患者接受了100个疗程的HPN治疗，用于治疗克罗恩病的并发症。六个登记中心提供了87%的治疗疗程。短肠综合征是60名患者的致病因素，29名患者存在瘘管，41名患者病情加重。30名患者有不止一种并发症。克罗恩病患者的年龄分布与所有HPN患者相同。9名患者死亡，8名患者因治疗并发症而停止HPN治疗。52%的患者没有并发症。接受HPN治疗的克罗恩病患者的生活质量明显优于整个患者群体（P<0.05），败血症和并发症发生率较低（分别为P<0.01和0.001）。60名患有短肠综合征的克罗恩病患者接受HPN治疗的时间明显长于总体克罗恩病患者（P<0.05）。这些患者中只有15人能够停止治疗并恢复肠内喂养，而其他40名患者中有23人在中位时间三个月后能够恢复肠内营养。对作者纳入100例患者中的35例患者进行分析发现，监测患者健康状况时唯一有用的营养参数是体重和血清白蛋白。接受HPN治疗的克罗恩病患者中有80%要么成功恢复了肠内喂养，要么成功地自行管理HPN。HPN是治疗克罗恩病急性或慢性肠衰竭患者的一种安全有效的方法。
