食管癌患者围放疗期营养管理指南的质量评价

doi:10.3761/j.issn.0254-1769.2021.05.022

摘要/Abstract

摘要：

目的对食管癌患者围放疗期营养管理相关指南及专家共识进行质量评价,并汇总相关推荐意见,为制订食管癌患者围放疗期营养护理实践标准提供参考。方法计算机检索国内外指南网、相关学会网站及数据库中关于食管癌患者围放疗期营养管理的相关指南及专家共识,检索时限为建库至2020年4月28日。采用标准的质量评价工具对指南及专家共识进行质量评价,汇总食管癌患者围放疗期营养管理相关推荐意见。结果共纳入5篇指南和4篇专家共识。5篇指南中1篇为A级推荐、4篇为B级推荐;4篇专家共识的质量评价结果中条目1~5均为“是”、条目6均为“否”。食管癌患者围放疗期营养管理相关推荐意见涉及营养不良诊断、营养治疗、营养素、改善食欲、维持吞咽功能、运动、家庭营养治疗、营养治疗的效果评价、随访9个方面,共23项内容。结论纳入的指南和专家共识质量有待提高,汇总的食管癌患者围放疗期营养管理相关推荐意见可为进一步制订营养护理实践标准提供参考。

关键词: 食管肿瘤, 放疗, 营养支持, 营养疗法, 指南, 循证护理学

Abstract:

Objective To evaluate the quality of nutritional management guidelines and expert consensuses for esophageal cancer during the peri-radiotherapy period and to summarize the relevant recommendations,so as to provide references for the establishment of the practice standards of nutritional care for esophageal cancer during the peri-radiotherapy period.Methods Guidelines and expert consensuses involving recommendations on nutritional management for esophageal cancer during the peri-radiotherapy period were searched in guideline networks,websites of nutritional associations and databases from their inception to April 28,2020. Related quality assessment tools were used to evaluate the quality of guidelines and expert consensuses. The recommendations on nutritional management for esophageal cancer during the peri-radiotherapy period were synthesized.Results A total of 5 guidelines and 4 expert consensuses were included. 1 of the 5 guidelines was rated as grade A recommendation,and 4 were rated as B. Items 1~5 in the quality evaluation results of the 4 expert consensuses were "yes" and item 6 was "no". The recommendations on nutritional management for esophageal cancer during the peri-radiotherapy period involved malnutrition diagnosis,nutrition treatment,nutrients,improvement of appetite,maintenance of swallowing function,exercise,home nutrition treatment,efficacy evaluation of nutrition treatment and follow-up.Conclusion The quality of included guidelines and expert consensus needs to be improved. The summary of nutritional management recommendations for esophageal cancer patients during the peri-radiotherapy period can provide reference for further formulating practice standards of nutritional care.

Key words: Esophageal Neoplasm, Radiotherapy, Nutritional Support, Nutrition Therapy, Guideline, Evidence-Based Nursing

王沛如,罗泽槟,张佳,郭植君,李丹丹,王逸如. 食管癌患者围放疗期营养管理指南的质量评价[J]. 中华护理杂志, 2021, 56(5): 767-774.

WANG Peiru,LUO Zebing,ZHANG Jia,GUO Zhijun,LI Dandan,WANG Yiru. Quality appraisal of guidelines on nutritional management for esophageal cancer during the peri-radiotherapy period[J]. Chinese Journal of Nursing, 2021, 56(5): 767-774.

图/表 4

表1 纳入指南和专家共识的基本特征

Table 1 Basic characteristics of included guidelines and expert consensuses

表2 纳入指南的质量评价结果及评价者间一致性检验结果（n=5）

Table 2 The AGREE Ⅱ evaluation results and the consistency test results among reviewers in the included guidelines（n=5）

表3 纳入专家共识的质量评价结果及评价者间一致性检验结果（n=4）

Table 3 The quality evaluation results and the consistency test results among reviewers in the included expert consensuses（n=4）

表4 食管癌患者围放疗期营养管理相关推荐意见汇总

Table 4 Summary of recommendations on nutritional management for esophageal cancer during the peri-radiotherapy period

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