Burgess P, Irving M H
Baillieres Clin Gastroenterol. 1988 Oct;2(4):905-14. doi: 10.1016/0950-3528(88)90041-3.
Home parenteral nutrition services have revolutionized the treatment, and improved the survival, of patients with prolonged or permanent intestinal failure. Without such a programme, these patients either would be condemned to continuous in-patient parenteral nutrition or to death. The indications for HPN in the UK remain predominantly intestinal failure resulting from inflammatory bowel disease, and major small bowl resection. Nearly 50% of patients receiving HPN will ultimately have normal intestinal function restored and thus be able to return to enteral feeding. This knowledge is reflected in the selection criteria for instituting HPN. The use of HPN in patients with malignant disease poses significant ethical questions. The success of HPN is dependent upon the organization of nutritional units to allow centralization of HPN programmes and to provide the necessary support to patients. It is clear that not all patients will benefit from HPN, and it is only by careful assessment of patients, based on the experience of specialized nutritional units, that a rational HPN service can be provided.
家庭肠外营养服务彻底改变了长期或永久性肠衰竭患者的治疗方式，并提高了其生存率。如果没有这样一个项目，这些患者要么注定要持续接受住院肠外营养，要么面临死亡。在英国，家庭肠外营养的适应证主要仍是炎症性肠病和小肠大部切除所致的肠衰竭。近50%接受家庭肠外营养的患者最终肠道功能会恢复正常，从而能够恢复肠内喂养。这一认识体现在启动家庭肠外营养的选择标准中。在恶性疾病患者中使用家庭肠外营养引发了重大的伦理问题。家庭肠外营养的成功依赖于营养单元的组织，以便集中开展家庭肠外营养项目并为患者提供必要的支持。显然，并非所有患者都能从家庭肠外营养中获益，只有基于专业营养单元的经验对患者进行仔细评估，才能提供合理的家庭肠外营养服务。
