口腔癌围手术期患者营养管理的证据总结  

Evidence summary of nutrition management in patients with oral cancer during the perioperative period

作　　者：张静[1] 李全 杨悦[1] Zhang Jing;Li Quan;Yang Yue(Department of Oral and Maxillofacial Surgery,Peking University Hospital of Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医院口腔颌面外科,北京100081

出　　处：《中华现代护理杂志》2021年第13期1681-1688,共8页Chinese Journal of Modern Nursing

摘　　要：目的:检索、评价和总结口腔癌患者围手术期营养管理的相关证据。方法:计算机检索BMJ最佳临床实践、英国国家医疗保健优化研究所指南库、国际指南协作网、苏格兰学院间指南网、加拿大安大略注册护士协会、美国肠内肠外营养学会、欧洲临床营养和代谢学会、中华医学会肠外肠内营养学分会、梅斯医学网、医脉通、Cochrane Library、JBI澳大利亚循证卫生保健中心、PubMed、Embase、CINAHL、中国生物医学文献服务系统、CNKI、万方数据库的临床实践指南、专家共识、推荐实践、最佳实践、证据总结、系统评价,检索时限为建库至2020年4月30日。应用标准的方法学质量评价工具和证据分级系统,对文献进行质量评价、证据提取、证据汇总及证据分级。结果:共纳入10篇文献,其中指南5篇,系统评价1篇,专家共识4篇。总结出28条口腔癌患者围手术期营养管理的最佳证据,包括营养风险筛查和营养评估、营养支持的原则、营养支持方式的选择、营养支持的措施、出院指导5个方面。结论:本研究总结了有关口腔癌患者围手术期营养管理的最佳证据,但其推荐意见散在分布,缺乏针对口腔癌患者的具体饮食指导,部分推荐意见尚有争议。因此,建议临床医护人员在参考本研究内容的基础上结合科室的条件和患者的需求,经过多学科的协作构建个性化的营养管理方案,促进证据的转化和有效应用。Objective To retrieve,evaluate and summarize the relevant evidence of perioperative nutritional management of oral cancer patients.Methods Databases and websites retrieved by computer were BMJ Best Clinical Practice,National Institute for Health and Care Excellence,Guidelines International Network,Scottish Intercollegiate Guidelines Network,Registered Nurses Association of Ontario,American Society for Parenteral and Enteral Nutrition,European Society for Clinical Nutrition and Metabolism,Chinese Society for Parenteral and Enteral Nutrition,MedSci Network,Medlive,Cochrane Library,JBI Australian Evidence-based Health Care Center,PubMed,Embase,CINAHL,SinoMed,China National Knowledge Infrastructure and Wanfang Database.Clinical practice guidelines,expert consensus,recommended practices,best practices,evidence summaries and systematic reviews in these databases were searched,and the search time limit was from the establishment of the databases to April 30,2020.Standard methodological quality assessment tools and evidence grading system were used to evaluate the quality of literature,extract evidence,summarize evidence and grade evidence.Results A total of 10 articles were included,including 5 guidelines,1 systematic review and 4 expert consensus.This paper summarized 28 best evidences of nutritional management in patients with oral cancer during perioperative period,including nutritional risk screening and nutritional assessment,principles of nutritional support,selection of nutritional support methods,measures of nutritional support and discharge guidance.Conclusions This study summarized the best evidences on perioperative nutritional management in patients with oral cancer,but its recommendations are widely distributed and lack specific dietary guidelines for patients with oral cancer,and some of the recommendations are still controversial.Therefore,it is suggested that clinical medical staff should combine conditions of departments and needs of patients on the basis of reference to contents of this study and build

关 键 词：口腔肿瘤 围手术期 营养支持 循证护理 

分 类 号：R473.73[医药卫生—护理学]