Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, UK.
Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.
Clin Nutr ESPEN. 2021 Apr;42:138-141. doi: 10.1016/j.clnesp.2020.12.029. Epub 2021 Feb 11.
Use of HPN in paediatrics in the UK has increased rapidly over the last 20 years but the prevalence of HPN has been challenging to define. Clinicians in the UK have noted an evolving complexity of cases and perceive improved outcomes and increased acceptability of long-term PN. These factors combined have the potential to increase the burden on existing paediatric gastroenterology services in the UK.
A national database was interrogated to define the prevalence of HPN in children in the UK and to explore outcomes for patients receiving HPN.
Since 2015, 525 children were notified to the database; of these patients, mortality was <5% and intestinal transplant occurred in 1%. In 2019, 389 children received HPN in the UK; this is nearly double the number last reported in 2012 and is a prevalence of 30 per million children. Short bowel syndrome is the largest category of these patients. However, a poorly defined group including those with multisystem disease has increased 10 fold since 2012 and is now the second largest category.
Long term HPN in childhood is safe and associated with good survival and low risk of the need for intestinal transplantation.
在过去的 20 年里，英国儿科中 HPN 的使用迅速增加，但 HPN 的流行率一直难以确定。英国的临床医生注意到病例的复杂性不断演变，并且认为 HPN 的治疗效果得到了改善，接受长期 PN 的意愿也有所增加。这些因素结合在一起，有可能增加英国现有儿科胃肠病学服务的负担。
对国家数据库进行了查询，以确定英国儿童中 HPN 的流行率，并探讨接受 HPN 的患者的结局。
自 2015 年以来，有 525 名患儿被通知到数据库；其中，死亡率<5%，1 例发生肠移植。2019 年，英国有 389 名儿童接受 HPN；这几乎是 2012 年报告数量的两倍，患病率为每百万儿童 30 例。短肠综合征是这些患者中最大的类别。然而，自 2012 年以来，包括多系统疾病在内的定义不明确的患者数量增加了 10 倍，现在是第二大类别。
儿童长期 HPN 是安全的，与良好的生存和低风险的肠移植需求相关。
