提升成人造血干细胞移植患者营养管理质量的证据总结

目的 检索、评价和整合造血干细胞移植患者饮食与营养管理的最佳证据。 方法 计算机检索Cochrane Library、PubMed、Medline、Embase、CINAHL、中国期刊全文数据库、万方数据库等文献数据库,以及美国指南网、苏格兰学院间指南网络、英国国家卫生和临床示范研究所、BMJ最佳临床实践、国际实践指南注册平台（中文）、Clinicalkey等指南相关专业官方网站有关成人造血干细胞移植患者饮食与营养管理相关的所有证据。 结果 共纳入7篇文献,其中指南4篇、证据总结1篇、系统评价2篇。从造血干细胞移植患者营养筛查与评估、膳食指导与营养教育、肠内营养与肠外营养、营养素的选择、肠道移植物抗宿主病患者的营养支持以及疗效评价与随访6个方面总结20条证据。 结论 临床护理人员需要重视造血干细胞移植患者的营养管理,根据临床实际情况以及患者意愿,合理选择最佳营养评估方法和营养支持策略,改善其营养不良状态,避免出现因长期营养不良所致的负性临床结局。

Evidence summary of management of nutrition support for adult patients underwent hematopoietic stem cell transplantation

Objective To retrieve,appraise and synthesize the best available evidence on management of nutrition support in adult patients underwent hematopoietic stem cell transplantation（HSCT）. Methods Websites of the Cochrane Library,PubMed,Medline,Embase,CINAHL,CNKI,Wanfang,the National Guideline Clearinghouse,Scottish Intercollegiate Guidelines Network,National Institute for Health and Clinical Excellence,BMJ Best Practice,International Practice Guideline Registry Platform（Chinese）and Clinicalkey were searched to collect literatures. Results Seven articles including 4 clinical practice guidelines,1 evidence summary,and 2 systematic reviews. A total of 20 items of best evidence were summarized regarding 6 aspects,which were nutrition screening and assessment,dietary counseling and nutrition education,enteral nutrition and parenteral nutrition,nutrition selection,nutrition support for patients with graft-versus-host disease（GVHD）,efficacy evaluation and follow-up of nutrition support. Conclusion Nursing staff should pay attention to nutrition management of patients underwent HSCT. Available best evidence of nutrition screening and nutrition support therapy are recommended to use according to characteristics of the hospital and clinical environment and patients' preference,in order to improve malnutrition and reduce negative clinical outcomes due to long-term malnutrition.