Parker T, Neale G, Cottee S, Elia M
Department of Dietetics, Addenbrooke's Hospital, Cambridge, U.K.
J R Coll Physicians Lond. 1996 Jan-Feb;30(1):27-32.
In the Cambridge health district the growth of artificial nutritional support was prospectively assessed over a five-year period (1988-93). The aim of this study was to investigate the variation in the prevalence of enteral tube feeding (ETF) and parenteral nutrition (PN) in hospital and at home and to assess the organisation. There was a fourfold variability in the prevalence of artificial nutritional support in the eight districts. The prevalence of home artificial nutrition doubled between 1988 and 1993, whilst that in hospital increased to a smaller extent (31%). Overall standards of care are not keeping pace with the demand for artificial nutritional support. Only half the districts had nutrition teams, and only one had a specialist nutrition sister. Policies about ETF and PN in hospital and at home were judged to be variable in quality. About one in five patients (or carers) at home experienced problems related to organisation of nutrition support services. General practitioners were also frequently uncertain about their role in managing patients on artificial nutrition at home. Home ETF is a rapidly growing form of home care therapy in East Anglia; in 1992-93 it was quantitatively as important as ETF in hospital. Improvements in organisation are recommended.
在剑桥健康区，对人工营养支持的增长情况进行了为期五年（1988 - 1993年）的前瞻性评估。本研究的目的是调查医院和家庭中肠内管饲（ETF）和肠外营养（PN）的普及率差异，并评估其组织情况。八个区的人工营养支持普及率存在四倍的差异。1988年至1993年间，家庭人工营养的普及率翻了一番，而医院中的普及率增长幅度较小（31%）。总体护理标准未能跟上对人工营养支持的需求。只有一半的区有营养团队，只有一个区有专业的营养护士。关于医院和家庭中ETF和PN的政策，其质量被判定参差不齐。约五分之一的家庭患者（或护理人员）在营养支持服务的组织方面遇到问题。全科医生在管理家庭中接受人工营养的患者时，也常常对自己的角色感到不确定。家庭ETF是东安格利亚地区一种迅速发展的家庭护理治疗形式；在1992 - 1993年，其在数量上与医院中的ETF同样重要。建议改进组织工作。
