上消化道术后患者肠内营养喂养不耐受预防及管理的最佳证据总结

目的 检索并评价上消化道术后患者肠内营养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 系统检索万方、PubMed、Cochrane Library、医脉通和欧洲临床营养和代谢学会等数据库、指南网站以及专业协会的所有关于上消化道术后患者肠内营养喂养不耐受预防及管理的证据,包括临床决策、临床实践指南、证据总结、系统评价及专家共识,检索从建库到2020年10月20日。由2名研究者独立对纳入的文献进行质量评价与证据提取。结果 共纳入10篇文献,从评估、营养制剂配方、喂养方案、药物使用、预防及处理6个方面汇总22条最佳证据。结论 本研究为临床医护人员提供了上消化道术后患者肠内营养喂养不耐受预防及管理的实践参考,建议在评估机构环境及利益相关者的意愿后选择性应用最佳证据,以提升护理质量。

Best Evidence Summary for Prevention and Management of Enteral Feeding Intolerance in Patients after Upper Gastrointestinal Surgery

Objective To select, evaluate and summarize the best evidence on prevention and management of feeding intolerance in patients after upper gastrointestinal surgery. Methods We systematically searched websites of professional organizations, websites of clinical practice guidelines and databases for guidelines, evidence summary, systematic review and expert consensus from the inception to October 20, 2020. Research quality evaluation and evidence extraction were conducted independently by 2 researchers. Results Ten articles were selected, and 22 pieces of best evidence were summarized, including assessment, enteral formula, drug administration, enteral feeding protocol, prevention and management. Conclusion The best evidence on prevention and management of feeding intolerance in patients after upper gastrointestinal surgery provides reference for improving the quality of nursing care, and best evidence should be applied with the consideration of environment,conditions, and stakeholder’s willingness.