肿瘤术后辅助化疗患者特殊用途配方食品营养管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2024.08.006

摘要/Abstract

摘要：

目的汇总肿瘤术后辅助化疗患者特殊用途配方食品营养支持治疗的最佳证据，为肿瘤术后辅助化疗患者的营养管理提供参考。方法计算机检索UpToDate、国际指南网、美国国立指南网、美国国立综合癌症网络、英国国家卫生与临床优化研究所网站、美国肿瘤护理协会网站、美国肠外肠内营养学会网站、欧洲临床营养与代谢协会网站、中华医学会肠外肠内营养学分会网站、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、Cochrane Library、PubMed、CINAHL、Scopus、Web of Science、Embase、中国生物医学文献数据库、万方数据库、中国知网中关于肿瘤术后辅助化疗患者特殊用途配方食品营养支持治疗的相关证据。检索时限为2012年1月1日—2022年8月14日。由2名经过循证培训的研究者独立完成文献的质量评价，并结合专家的建议进行证据提取及总结。结果共纳入14篇文献，包括4篇指南、1篇临床决策、2篇系统评价、4篇专家共识、3篇随机对照试验。汇总了14条最佳证据，涉及营养筛查与评估、营养教育、推荐剂量、配方选择、营养治疗和不良反应处理6个方面。结论该研究总结的最佳证据具有科学性和系统性，在对患者实施营养治疗时，医护人员应充分评估患者的营养状况，审慎地选择特殊用途配方食品剂量及种类，指导患者安全、有效地改善自身营养状况，提高患者的生活质量。

关键词: 肿瘤, 特殊用途配方食品, 营养管理, 循证护理学, 证据总结

Abstract:

Objective To summarize the best evidence of nutritional support therapy with food for special medical purpose for patients undergoing adjuvant chemotherapy after oncology surgery，and to provide a reference basis for standardizing the application of food for special medical purpose and guiding clinical nutritional therapy practice for oncology patients. Methods Computer search was conducted on UpToDate，Guidelines International Network（GIN），National Guideline Clearinghouse，National Comprehensive Cancer Network，National Institute for Health and Clinical Excellence，Oncology Nursing Society，American Society for Parenteral Enteral Nutrition，European Society for Clinical Nutrition and Metabolism，Chinese Society for Parenteral and Enteral Nutrition，Joanna Briggs Institute Evidence-Based Health Care Centre database，Cochrane Library，PubMed，CINAHL，Scopus，Web of Science，Embase，CBM，Wanfang，and China Knowledge Network on the nutritional support treatment of food for special medical purpose for postoperative adjuvant chemotherapy patients. The retrieval period was from January 2012 to August 2022. Quality evaluation of the literature was completed independently by 2 evidence-based trained researchers and combined with expert advice to extract and summarise evidence for the literature that met quality standards. Results A total of 14 articles were included，including 4 guidelines，1 clinical decision，2 systematic reviews，4 expert consensuses，and 3 randomized controlled trials. The 14 pieces of best evidence were compiled，covering 6 aspects of nutritional screening and assessment，nutritional education，recommended dose，formulation selection，nutritional treatment，and management of adverse effects. Conclusion This study summarises the best evidence on the nutritional management of food for special medical purpose in postoperative adjuvant chemotherapy patients with cancer，which is scientific and systematic. When administering nutritional therapy to patients，healthcare professionals should fully assess the nutritional status of patients，make clear and prudent choices on the dosage and type of food for special medical purpose to be used by patients，and guide patients to improve their nutritional status safely and effectively to improve their quality of life. To improve the quality of life.

Key words: Neoplasms, Food for Special Purpose, Nutritional Management, Evidence-Based Nursing, Evidence Summary

高超越, 李敏, 张银珠, 张培莉, 侯晓雅, 程伊霞. 肿瘤术后辅助化疗患者特殊用途配方食品营养管理的最佳证据总结[J]. 中华护理杂志, 2024, 59(8): 934-940.

GAO Chaoyue, LI Min, ZHANG Yinzhu, ZHANG Peili, HOU Xiaoya, CHENG Yixia. Evidence summary of nutritional management of food for special medical purpose in postoperative adjuvant chemotherapy patients with cancer[J]. Chinese Journal of Nursing, 2024, 59(8): 934-940.

图/表 4

图1 文献筛选流程图

Figure 1 Flow chart of literature screening

表1 纳入文献的基本特征（n=14）

Table 1 Characteristics of included literature（n=14）

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 肿瘤术后辅助化疗患者特殊用途配方食品营养管理的最佳证据

Table 3 Evidence summary of nutritional management of food for special medical purpose in postoperative adjuvant chemotherapy patients with cancer

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