失代偿性肝硬化患者肠内营养风险评估及管理方案的构建

目的 构建失代偿性肝硬化患者肠内营养风险评估及管理方案,为临床干预提供参考依据。 方法 检索国内外数据库获取相关文献,初步拟订失代偿性肝硬化患者肠内营养风险及管理方案,于2021年9月—11月采用德尔菲法进行2轮专家函询,确定方案内容。 结果 共14名专家完成2轮函询。2轮函询中,专家的权威系数分别为0.838和0.839。第2轮函询中,一、二、三级指标的肯德尔和谐系数分别为0.836、0.714、0.683（P<0.05）,各指标的变异系数为0~0.23。最终构建的失代偿性肝硬化患者营养风险评估及管理方案包括5项一级指标、14项二级指标、18项三级指标。 结论 该研究构建的失代偿性肝硬化患者肠内营养风险评估及管理方案具有较好的科学性、可靠性、实用性,可为临床干预提供参考依据。

Risk assessment and management scheme of enteral nutrition in patients with decompensated liver cirrhosis

Objective To establish an enteral nutrition risk assessment and management scheme for patients with decompensated liver cirrhosis and to provide a reference for clinical practice. Methods The literature related to the risk assessment and management of enteral nutrition in patients with decompensated liver cirrhosis was searched in domestic and international databases. The research team members formed an enteral nutrition risk and management scheme primarily for patients with decompensated liver cirrhosis,and then 2 rounds of expert correspondence were conducted to revise the draft and determine the content by Delphi method from September to November 2021. Results 14 experts were included,and the authoritative coefficients of the 2 rounds of correspondence with experts were 0.838 and 0.839,respectively. The Kendal harmony coefficient and expert coordination coefficient of the primary,secondary,and tertiary indicators were 0.836,0.714 and 0.683 in the second-round correspondence,and the coefficient of variation of each indicator ranged from 0 to 0.23. A final version of nutritional risk assessment and management scheme for patients with decompensated liver cirrhosis was finally constructed,including 5 first-level indicators,14 second-level indicators,and 18 third-level indicators. Conclusion The established enteral nutrition risk assessment and management scheme for patients with decompensated liver cirrhosis is rigorous,scientific,and reliable,which can provide a reference for clinical practice.