PDF(Pubmed)
Abstract：
BACKGROUND: Intestinal failure, defined as the loss of gastrointestinal function to the point where nutrition cannot be maintained by enteral intake alone, presents numerous challenges in children, not least the timing of consideration of intestine transplantation.
OBJECTIVE: To describe the evolution of care of infants and children with intestinal failure including parenteral nutrition, intestine transplantation, and contemporary intestinal failure care.
METHODS: The review is based on the authors\' experience supported by an in-depth review of the published literature.
RESULTS: The history of parenteral nutrition, including out-patient (home) administration, and intestine transplantation are reviewed along with the complications of intestinal failure that may become indications for consideration of intestine transplantation. Current management strategies for children with intestinal failure are discussed along with changes in need for intestine transplantation, recognizing the difficulty in generalizing recommendations due to the high level of heterogeneity of intestinal pathology and residual bowel anatomy and function.
CONCLUSIONS: Advances in the medical and surgical care of children with intestinal failure have resulted in improved transplant-free survival and a significant fall in demand for transplantation. Despite these improvements a number of children continue to fail rehabilitative care and require intestine transplantation as life-saving therapy or when the burden on ongoing parenteral nutrition becomes too great to bear.
OBJECTIVE: To describe the evolution of care of infants and children with intestinal failure including parenteral nutrition, intestine transplantation, and contemporary intestinal failure care.
METHODS: The review is based on the authors\' experience supported by an in-depth review of the published literature.
RESULTS: The history of parenteral nutrition, including out-patient (home) administration, and intestine transplantation are reviewed along with the complications of intestinal failure that may become indications for consideration of intestine transplantation. Current management strategies for children with intestinal failure are discussed along with changes in need for intestine transplantation, recognizing the difficulty in generalizing recommendations due to the high level of heterogeneity of intestinal pathology and residual bowel anatomy and function.
CONCLUSIONS: Advances in the medical and surgical care of children with intestinal failure have resulted in improved transplant-free survival and a significant fall in demand for transplantation. Despite these improvements a number of children continue to fail rehabilitative care and require intestine transplantation as life-saving therapy or when the burden on ongoing parenteral nutrition becomes too great to bear.
摘要：
背景：肠衰竭，定义为胃肠功能丧失到不能单独通过肠内摄入维持营养的程度，给儿童带来了许多挑战，尤其是考虑肠道移植的时机。
目的：描述包括肠外营养在内的肠衰竭婴儿和儿童护理的演变，肠移植,和当代肠衰竭护理。
方法：本综述基于作者的经验，并对已发表的文献进行了深入的综述。
结果：肠外营养史，包括门诊(家庭)管理，回顾了肠移植以及肠衰竭的并发症，这些并发症可能成为考虑肠移植的适应症。讨论了肠衰竭儿童的当前管理策略以及肠移植需求的变化。认识到由于肠道病理和残余肠解剖结构和功能的高度异质性，难以推广建议。
结论：肠衰竭患儿的内科和外科护理的进展导致无移植存活率的提高和移植需求的显著下降。尽管有这些改善，许多儿童仍然无法通过康复护理，需要肠道移植作为挽救生命的疗法，或者当正在进行的肠胃外营养负担变得太大而无法承受时。
目的：描述包括肠外营养在内的肠衰竭婴儿和儿童护理的演变，肠移植,和当代肠衰竭护理。
方法：本综述基于作者的经验，并对已发表的文献进行了深入的综述。
结果：肠外营养史，包括门诊(家庭)管理，回顾了肠移植以及肠衰竭的并发症，这些并发症可能成为考虑肠移植的适应症。讨论了肠衰竭儿童的当前管理策略以及肠移植需求的变化。认识到由于肠道病理和残余肠解剖结构和功能的高度异质性，难以推广建议。
结论：肠衰竭患儿的内科和外科护理的进展导致无移植存活率的提高和移植需求的显著下降。尽管有这些改善，许多儿童仍然无法通过康复护理，需要肠道移植作为挽救生命的疗法，或者当正在进行的肠胃外营养负担变得太大而无法承受时。
