胃癌患者围手术期口服营养补充管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2025.03.014

摘要/Abstract

摘要：

目的检索、筛选、评价和总结胃癌患者围手术期口服营养补充（oral nutritional supplement，ONS）管理的最佳证据，为临床制订规范化ONS管理方案提供参考。方法系统检索美国国立指南网、英国国家卫生与临床优化研究所网站、苏格兰院际指南网等网站和Cochrane Library、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等数据库中发表的指南、证据总结、系统评价、专家共识、标准，检索时限为建库至2024年3月。由2名接受过循证护理学培训的研究者分别对纳入文献进行质量评价、证据提取和证据分级。结果共纳入21篇文献，包括4篇指南、 6篇证据总结、5篇专家共识和6篇系统评价。汇总出包括组建多学科团队、健康教育、ONS种类选择和营养素配比、术前ONS评估与管理、术后ONS管理和出院ONS指导6个主题，共28条证据。结论该研究汇总的胃癌患者围手术期ONS管理最佳证据具有全面性和科学性，为医护人员系统、规范地管理胃癌患者围手术期ONS提供循证依据。

关键词: 胃肿瘤, 围手术期, 口服营养补充, 肠内营养, 证据总结, 循证护理学

Abstract:

Objective To search，select，evaluate and summarize the best evidence of perioperative oral nutritional supplement management in patients with gastric cancer，so as to provide references for the formulation of standardized oral nutritional supplement management program in clinical practice. Methods Guidelines，evidence summaries，systematic reviews，expert consensuses and group standards were systematically and completely retrieved from NGC，NICE，SIGN and other websites，as well as Cochrane Library，JBI and other databases. The retrieve time limit was from the database construction to March，2024. Totally 2 researchers trained in evidence-based nursing independently evaluated the quality of the literature，extracted the evidence，and classified the evidence level. Results A total of 21 articles were involved，including 4 guidelines，6 evidence summaries，5 expert consensuses and 6 systematic reviews. 28 pieces of best evidence on 6 topics were summarized，including the establishment of multidisciplinary teams，health education，type selection and target requirement of oral nutritional supplement，preoperative oral nutritional supplement management，postoperative oral nutritional supplement management，and discharge oral nutritional supplement guidance. Conclusion This study summarized the comprehensive and scientific best evidence of oral nutritional supplement management for patients with perioperative gastric cancer，providing evidence-based support for medical staff to manage the oral nutritional supplement in perioperative gastric cancer patients systematically and standardly.

Key words: Stomach Neoplasms, Perioperative Period, Oral Nutritional Supplement, Enteral Nutrition, Evidence Summary, Evidence-Based Nursing

宗小燕, 李红燕, 韩小云, 景新华. 胃癌患者围手术期口服营养补充管理的最佳证据总结[J]. 中华护理杂志, 2025, 60(3): 355-363.

ZONG Xiaoyan, LI Hongyan, HAN Xiaoyun, JING Xinhua. Summary of the best evidence for perioperative management of oral nutritional supplementation in patients with gastric cancer[J]. Chinese Journal of Nursing, 2025, 60(3): 355-363.

图/表 3

图1 文献筛选流程

Figure 1 Flow chart of literature screening

表1 纳入文献的一般特征（n=21）

Table 1 Characteristics of included literature（n=21）

表2 胃癌患者围手术期口服营养补充管理的最佳证据总结

Table 2 Evidence summary of oral nutritional supplement management in perioperative gastric cancer patients

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