Abstract:

Objective To select and obtain the best evidence on management and prevention of feeding intolerance in preterm infants,and to summarize the best evidence available. Methods We searched the UpToData,Joanna Briggs Institute（JBI）,Guidelines International Network（GIN）,National Guideline Clearing house（NGC）,National Institute for Health and Care Excellence（NICE）,Registered Nurses’ Association of Ontario（RNAO）,Scottish Intercollegiate Guidelines Network（SIGN）,Cochrane Library,PubMed,Embase,CINAHL,American Society for Nutrition（ASN）,and complementally searched the CNKI,the CBM and WanFang database,to collect relevant guideline,evidence summary,best practice information sheet,recommended practice,systematic review,expert consensus and original study. The time limit for the retrieval is from the inception of databases until August 30,2019. 2 investigators evaluated the quality of the included literature and extracted evidence from documents that met the quality criteria. Results Totally 11 articles were selected,and 18 pieces of best evidence were summarized,including the influencing factors of feeding intolerance,evaluation criteria,prevention,management and outcome indicators. Conclusion Our research summed up the best evidence on prevention and management of feeding intolerance in premature infants. In order to improve the quality of nursing care,selective evidence should be applied with the consideration of environment,conditions and patient’s willingness.

Key words: Preterm Infant, Very Low Birth Weight Infant, Enteral Nutrition, Feeding Intolerance, Evidence-Based Nursing

摘要：

目的 遴选并获取国内外早产儿喂养不耐受预防及管理的相关证据,并对最佳证据进行总结。方法 系统检索UptoDate、乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南图书馆、美国指南网、英国国家卫生与临床优化研究所、加拿大安大略注册护士学会网站、苏格兰院际指南网、Cochrane Library、PubMed、荷兰医学文摘数据库（Embase）、CINAHL、美国营养学会（American Society for Nutrition,ASN）、中国指南网、中国知网、万方数据库及中国生物医学文摘数据库关于早产儿喂养不耐受预防及管理的所有证据,包括指南、证据总结、临床决策、系统评价、专家共识及相关原始研究,检索时限为建库至2019年8月30日。由2名研究者对纳入的文献质量进行评价,并对符合质量标准的文献进行证据提取。 结果 共纳入11篇文献,从喂养不耐受的影响因素、评估标准、预防、处理及结局指标5个方面汇总18条最佳证据。 结论 本研究为临床医护人员提供了早产儿喂养不耐受预防及管理的循证依据,建议在评估所在医疗机构的临床环境条件及患儿家长的意愿后选择性应用最佳证据,以提升护理质量。

关键词: 早产儿, 极低出生体重儿, 肠内营养, 喂养不耐受, 循证护理学