肝硬化患者营养评估与管理的最佳证据总结

doi:10.3761jissn.0254-1769.2020.09.027

摘要/Abstract

摘要：

目的检索、评价和汇总肝硬化患者营养评估与管理的最佳证据。方法检索Cochrane Library、CINAHL、澳大利亚乔安娜布里格斯研究所循证卫生保健国际合作中心图书馆、BMJ Best Practice、UpToDate等指南网,欧洲肝脏疾病研究协会、韩国肝脏疾病研究协会、美国肝病研究协会等专业学会网站,Medline、Elsevier、Web of Science、Embase、PubMed、万方、中国知网等数据库,获取关于肝硬化患者营养评估与管理相关的所有证据。结果共纳入10篇文献,其中指南8篇,专家共识和系统评价各1篇,共汇总了21条最佳证据,主要涉及肝硬化患者的营养风险筛查、营养评估、能量及蛋白质的摄入、进食次数、进餐方式、并发症的管理和健康教育7个方面。结论肝硬化患者营养评估与管理的最佳证据内容丰富,但部分证据源于国外的循证资源,在应用时仍需进行本土化。

关键词: 肝硬化, 营养评估, 营养支持, 循证护理学

Abstract:

Objective To search,evaluate,and summarize the best evidence for nutritional assessment and management in patients with cirrhosis.Methods Cochrane Library,CINAHL,Joanna Briggs Institute Library,BMJ BestPractice,UpToDate,European Association for the Study of the Liver,the Korean Association for the Study of the Liver,American Association for the Study of Liver Diseases,Medline,Elsevier,Web of Science,Embase,PubMed,Wanfang and CNKI were searched to collect the literature.Results A total of 10 pieces of literature were included,among which 6 were originated from abroad and 4 were from China,including 8 guidelines,1 expert consensus,and 1 systematic review. A total of 21 pieces of best evidence were collected,mainly involving 7 aspects of nutrition risk screening,nutrition assessment,energy and protein intake,frequency of meals,meals,management of complications and health education in patients with liver cirrhosis.Conclusion The best evidence of nutritional assessment and management of patients with liver cirrhosis is abundant in content,but some evidence was from foreign evidence-based resources,while localization remains to be done at the time of application.

Key words: Liver Cirrhosis, Nutritional Assessment, Nutritional Support, Evidence-Based Nursing

庞永丽,方蘅英,罗媛容,顾娇娇,陈妙霞. 肝硬化患者营养评估与管理的最佳证据总结[J]. 中华护理杂志, 2020, 55(9): 1420-1425.

PANG Yongli,FANG Hengying,LUO Yuanrong,GU Jiaojiao,CHEN Miaoxia. Best evidence summary of nutritional assessment and management in patients with liver cirrhosis[J]. Chinese Journal of Nursing, 2020, 55(9): 1420-1425.

图/表 5

表1 纳入文献的基本特征

表2 纳入指南的临床指南研究与评价系统评价结果(n=8)

表3 纳入专家共识的质量评价结果(n=1)

表4 纳入系统评价的质量评价结果（n=2）

表5 肝硬化患者营养评估与管理的最佳证据总结

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