住院患者肠外营养支持并发症预防的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.11.011

摘要/Abstract

摘要：

目的评价并总结住院患者肠外营养支持并发症预防的相关证据，为医护人员制订科学、规范的预防措施提供循证依据。方法计算机检索UpToDate、BMJ最佳临床实践、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、加拿大安大略省注册护士协会网站、英国国家卫生与临床优化研究所网站、苏格兰学院间指南网、国际指南网、新西兰指南协作组、美国肠外和肠内营养学会网站、欧洲临床营养与代谢学会网站、国际实践指南注册平台中国临床指南文库、医脉通指南网、PubMed、Cochrane Library、Web of Science、CINAHL、Embase、中国生物医学文献数据库、中国知网、万方数据库中发表的相关文献，包括临床决策、证据总结、指南、专家共识、系统评价等，检索时限为建库至2023年10月。对文献进行筛选、质量评价后，进行证据提取及整合。结果共纳入16篇文献，包括3篇临床决策、1篇证据总结、4篇指南、6篇专家共识、2篇系统评价，从预防代谢性并发症、机械性并发症及感染性并发症3个方面提取了27条最佳证据。结论该研究总结了住院患者肠外营养支持并发症预防的相关证据，建议医护人员结合临床情景、患者情况，制订科学、规范的肠外营养支持并发症预防及处理措施。

关键词: 肠外营养, 营养支持, 并发症, 证据总结, 循证护理学

Abstract:

Objective To evaluate and summarize the evidence related to the prevention of parenteral nutritional support complications in inpatients，and to provide an evidence-based basis for guiding healthcare professionals to prevent parenteral nutritional support complications in a scientific and standardized manner. Methods Computerized search was conducted in UpToDate，BMJ Best Clinical Practice，Centre for Evidence-Based Health Care database of the Joanna Briggs Institute in Australia，Ontario Registered Nurses Association website in Canada，National Institute for Health and Clinical Excellence website in the United Kingdom，Scottish Intercollegiate Guidelines Network，Guidelines International，New Zealand Guidelines Collaborative，American Society for Parenteral and Enteral Nutrition website，European Society for Clinical Nutrition and Metabolism Society website，International Practice Guidelines Registry Platform China Clinical Guidelines Repository，Medical Pulse，PubMed，Cochrane Library，Web of Science，CINAHL，Embase，China Biomedical Literature Database，CNKI，Wanfang Database，etc. The search period was from the time of database construction to October 2023. After literature screening and quality evaluation，the evidence extraction and integration were carried out. Results A total of 16 papers were included，including 3 clinical decision-making，1 evidence summary，4 guidelines，6 expert consensuses，and 2 systematic evaluations. 27 pieces of best evidence were extracted from 3 areas，namely metabolic complications，mechanical complications，and infectious complications. Conclusion This study summarized the evidence related to the prevention and management of complications of parenteral nutrition support in adult inpatients，aiming to provide an evidence-based basis for healthcare professionals to develop scientific and standardized measures for the prevention and management of complications of parenteral nutrition support.

Key words: Parenteral Nutrition, Nutritional Support, Complications, Evidence Summary, Evidence-Based Nursing

姚亭, 高亚南, 徐涯鑫, 徐军, 陈亚梅. 住院患者肠外营养支持并发症预防的最佳证据总结[J]. 中华护理杂志, 2024, 59(11): 1360-1367.

YAO Ting, GAO Yanan, XU Yaxin, XU Jun, CHEN Yamei. Evidence summary of prevention complications for parenteral nutritional support in hospitalized patients[J]. Chinese Journal of Nursing, 2024, 59(11): 1360-1367.

图/表 5

图1 文献筛选流程

Figure 1 Flow chart of literature screening

表1 纳入文献的基本情况（n=16）

Table 1 Characteristics of included studies（n=16）

表2 临床决策及证据总结的质量评价结果（n=4）

Table 2 Quality evaluation of clinical decision-making and summaries（n=4）

表3 指南的质量评价结果（n=4）

Table 3 Evaluation results of the guidelines（n=4）

表4 住院患者肠外营养支持并发症预防的最佳证据总结

Table 4 Best evidence of prevention complications for parenteral nutritional support in adult hospitalized patients

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