Abstract:

Objective To retrieve，evaluate and synthesize the best evidence for nutritional management in patients with acute-on-chronic liver failure. Methods Evidence on nutritional management of patients with acute-on-chronic liver failure was systemically retrieved from the clinical decision support systems，guideline websites，professional association websites and databases，such as Cochrane Library，Joanna Briggs Institute，PubMed，Embase，CINAHL，Web of Science，VIP database，CNKI and CBM，including clinical decisions，guidelines，expert consensuses，evidence summaries and systematic reviews from inception to July 16，2024.Researchers trained in evidence-based nursing used authoritative tools to evaluate the methodological quality of the literature，and extracted and synthesized evidence according to the theme. Results A total of 13 articles were included，including 1 clinical decision，8 guidelines，and 4 expert consensuses. The best evidence included 26 pieces of evidence in 6 areas，namely the nutrition support team，nutritional assessment，energy and protein intake，oral nutrition support，enteral and parenteral nutrition support，and management of complications. Conclusion This study summarizes the best evidence for nutritional management in patients with acute-on-chronic liver failure，which can provide a basis for their standardized management.Medical staff should evaluate the availability of evidence from multiple perspectives when applying it.

Key words: Liver Failure, Acute-on-Chronic Liver Failure, Nutritional Support, Evidence-Based Nursing

摘要：

目的 检索、评价及汇总慢加急性肝衰竭患者营养管理的最佳证据。方法 系统检索国内外计算机决策系统、指南网站、专业协会网站及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、PubMed、Embase、CINAHL、Web of Science、维普数据库、中国知网、中国生物医学文献数据库中有关肝衰竭患者营养管理的临床决策、指南、专家共识、推荐实践、证据总结、系统评价等文献，检索时限为建库至2024年7月16日；由经过循证护理培训的研究人员采用权威工具对文献进行方法学质量评价，并根据主题对证据进行提取与综合。结果 共纳入13篇文献，包括1篇临床决策、8篇指南和4篇专家共识。从营养支持团队、营养评估、能量与营养素摄入、口服营养支持、肠内与肠外营养支持和并发症的管理等6个方面，汇总26条证据。结论 该研究总结了慢加急性肝衰竭患者营养管理的最佳证据，可为其规范管理提供依据，医护人员在应用证据时应多角度评估其可用性。

关键词: 肝衰竭, 慢加急性肝衰竭, 营养支持, 循证护理学