胃癌患者围手术期营养管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.19.006

摘要/Abstract

摘要：

目的检索并筛选胃癌围手术期营养管理的相关证据,并对最佳证据进行总结。方法计算机检索BMJ Best Practice、UpToDate、国际指南协作网、医脉通、英国国家卫生与临床优化研究所网站、苏格兰校际指南网、加拿大安大略注册护士协会网站、澳大利亚乔安娜布里格斯研究所循证卫生保健数据库、美国国家癌症综合网、欧洲临床营养与代谢学会网站、中华医学会肠外肠内营养学会网站、美国肠外肠内营养学会网站、Cochrane Library、PubMed、中国知网、万方数据库、维普数据库、中国生物医学文献数据库等发表的临床决策、指南、证据总结、专家共识、系统评价,检索时限为2012年1月—2022年4月。2名研究者对文献进行质量评价、证据提取与总结。结果共纳入15篇文献,包括临床决策1篇、指南4篇、证据总结1篇、专家共识5篇、系统评价4篇。总结出28条证据,包括营养风险筛查与评估、多学科团队、营养支持原则、术前营养支持、术后营养支持、出院及随访6个方面。结论该研究总结的胃癌患者围手术期营养管理的最佳证据具有科学性和系统性,为医护人员对胃癌围手术期患者实施营养管理提供循证依据。

关键词: 胃肿瘤, 围手术期, 围手术期护理, 营养不良, 营养支持, 循证护理学

Abstract:

Objective To search and select the evidence related to perioperative nutritional management of gastric cancer,and to summarize the best evidence. Methods We retrieved the BMJ best practice,Up to Date,Guidelines International Network,Medlive,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,Registered Nurses Association of Ontario,JBI,National Comprehensive Cancer Network,European Society for Clinical Nutrition and Metabolism,Chinese Society For Parenteral and Enteral Nutrition,American Society for Parenteral and Enteral Nutrition,Cochrane Library,PubMed,CNKI,Wanfang Database,VIP,SinoMed,and collected relevant clinical decisions,guidelines,evidence summaries,expert consensuses and systematic reviews. The search time limit was from January,2012 to April,2022. There were 2 researchers who evaluated the quality of the included literature,and extracted and summarized the evidence. Results A total of 15 articles were included,including 1 clinical decision,4 guidelines,1 evidence summary,5 expert consensuses,and 4 systematic reviews. 28 pieces of evidence were summarized,including nutritional risk screening and assessment,multidisciplinary team,general principles of nutritional support,preoperative nutritional support,postoperative nutritional support,discharge and follow-up. Conclusion The best evidence in this study is scientific and systematic,providing evidence-based interventions for medical workers to implement nutritional management of perioperative gastric cancer patients.

Key words: Stomach Neoplasms, Perioperative Period, Perioperative Nursing, Malnutrition, Nutritional Support, Evidence-Based Nursing

费超男, 段培蓓, 杨玲, 杜世正, 夏超, 杨丽萍, 乔悦. 胃癌患者围手术期营养管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(19): 2345-2352.

FEI Chaonan, DUAN Peibei, YANG Ling, DU Shizheng, XIA Chao, YANG Liping, QIAO Yue. Evidence summary of nutritional management in patients with gastric cancer during the perioperative period[J]. Chinese Journal of Nursing, 2022, 57(19): 2345-2352.

图/表 4

图1 文献筛选流程

Figure 1 The flow diagram of literature screening

表1 纳入文献的基本特征（n=15）

Table 1 Characteristics of included literature（n=15）

表2 纳入指南的质量评价结果（n=4）

Table 2 Quality evaluation of included guidelines（n=4）

表3 胃癌患者围手术期营养管理的最佳证据总结

Table 3 Evidence summary of nutritional management in patients with gastric cancer during the perioperative period

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