维持性血液透析患者透析期间饮食管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2021.10.007

摘要/Abstract

摘要：

目的检索、分析维持性血液透析患者透析期间饮食管理的相关证据,对最佳证据进行总结,为患者透析期间饮食管理提供循证依据。方法 2021年3月,依照证据金字塔模型检索相关文献,采用乔安娜布里格斯研究所循证卫生保健中心对应的文献评价标准和证据分级系统对文献进行质量评价,并对提取的证据进行等级划分。检索时限为建库至2021年3月24日。结果共纳入文献8篇,包括指南2篇、专家共识2篇、系统评价1篇、临床决策3篇,包括血液透析期间饮食管理人群、进食方式、进食种类、进食体位、进食量、食物性状6个方面,共汇总8条最佳证据。结论该研究总结的证据全面、实用,为规范患者透析期间的饮食方式以降低餐后低血压的发生及血液透析期间不良事件的发生、提升血液透析的护理质量提供借鉴,建议医护人员在应用证据时结合临床情境、证据的促进因素、阻碍因素及患者意愿等针对性地选择证据。

关键词: 维持性血液透析, 透析期间饮食, 饮食管理, 循证护理学

Abstract:

Objective To search, analyze and summarize the relevant evidence of diet management of maintenance hemodialysis（MHD） patients during hemodialysis treatment,and to summarize the best evidence,so as to provide evidence-based bases of diet management of MHD patients during hemodialysis treatment for clinical nurses. Methods In March,2021,based on the pyramid model of evidence,the relevant literature was searched by computer,and the literature quality was evaluated and the extracted evidence was graded by the literature evaluation standard and evidence grading system corresponding to Evidence-based Healthcare Center of Joanna Briggs Institute（JBI）. The search time was from the establishment of the database to March 24,2021. Results A total of 8 pieces of literature were included and summarized as the best evidence,including 2 guidelines,2 expert consensuses,1 systematic evaluation and 3 clinical decisions,covering 6 aspects of diet management population,eating style,diet type,eating position,diet amount and diet characteristics during hemodialysis treatment. Conclusion The evidence of diet management of MHD patients during hemodialysis treatment provides effective evidence for standardizing the diet style of patients to reduce the incidence of hypotension and adverse events and improve nursing quality during dialysis. It is suggested that targeted evidence should be selected in combination with clinical situations,promoting factors,hindering factors and patients’ wishes when the evidence is applied.

Key words: Maintenance Hemodialysis, Intradialytic Meals, Dietetic Management, Evidence-Based Nursing

顾勤, 吴桃峰, 陈静芳. 维持性血液透析患者透析期间饮食管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(10): 1485-1489.

GU Qin, WU Taofeng, CHEN Jingfang. Evidence-based practice of dietetic management in maintenance hemodialysis patients[J]. Chinese Journal of Nursing, 2021, 56(10): 1485-1489.

图/表 4

表1 纳入文献的基本特征（n=8）

Table 1 The basic characteristics of the included literature（n=8）

表2 指南的质量评价结果

Table 2 The quality evaluation results of the guidelines

表3 专家共识的质量评价结果

Table 3 The quality evaluation results of the consensus

表4 最佳证据总结

Table 4 Summary of the best evidence

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