关键词: 胰十二指肠切除术, 肠道营养, 康复护理, 循证护理学

Abstract:

Objective To retrieve the best evidence on early enteral nutrition in patients after pancreaticoduodenectomy（PD）and to summarize the best available evidence for clinical nurses to provide evidence-based guidance for the management. Methods All evidence on early enteral nutrition in patients after PD was retrieved from databases and websites including UpToDate,BMJ Best Practice,JBI Library,Cochrane Library,NICE,ASPEN,ESPEN,PubMed,CBM,VIP,CNKI and Wanfang. The retrieved evidence included guidelines,expert consensuses,evidence summaries,systematic reviews,meta-analysis and related original studies. The retrieval period was from the inception of databases to June 15,2020. 2 researchers with evidence-based nursing background assessed the quality of the literature independently,combined with the opinions of professionals,extracted and summarized the evidence of the literature that met the quality standards. Results A total of 281 references were obtained from the initial search,and 12 pieces of literature were included,including 4 guidelines,1 expert consensus,2 systematic evaluations and 5 meta-analysis. Finally,totally 11 pieces of best evidence were summarized from 4 aspects on indications and safety assessment of early enteral nutrition,timing of early enteral nutrition,route selection and target nutrient requirement management. Conclusion Early enteral nutrition after PD is safe and feasible. Evidence users should select best evidence based on the clinical context,the promoting factors and the obstacles and willingness of patients,so as to form a scientific and evidence-based practice plan for early enteral nutrition after PD management,and to accelerate patients’ recovery and improve nursing quality.

Key words: Pancreatoduodenectomy, Enteral Nutrition, Rehabilitation Nursing, Evidence-Based Nursing