成人住院患者经鼻行管饲喂养中口鼻腔护理的最佳证据总结  

Summary of the best evidence for oral and nasal care of adult inpatients during nasal tube feeding

作　　者：张锐[1] 叶向红 王慧君 顾璐璐 吴翠丽 Zhang Rui;Ye Xianghong;Wang Huijun;Gu Lulu;Wu Cuili(Medical School,Nanjing University,Nanjing 210093,China;Research Institute of General Surgery,General Hospital of Eastern Theater Command,Nanjing 210002,China;Graduate School,Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]南京大学医学院,南京210093 [2]东部战区总医院普通外科研究所,南京210002 [3]蚌埠医学院研究生院,蚌埠233000

出　　处：《中华现代护理杂志》2022年第13期1687-1692,共6页Chinese Journal of Modern Nursing

基　　金：军事医学创新工程项目(18CXZ040);南京军区军事医学科技创新课题(ZD32)。

摘　　要：目的基于循证的研究方法总结成人住院患者经鼻行管饲喂养中口鼻腔护理的证据,为临床实施提供参考。方法系统检索UpToDate、Joanna Briggs Institute(JBI)循证卫生保健中心数据库、美国国立指南网、英国国家卫生与临床优化研究所、中国医脉通指南网、Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方数据库等数据库和指南网站中关于经鼻行鼻饲喂养成人患者口鼻腔护理的相关证据,检索时限均为2016年1月1日—2020年8月28日。对纳入的临床实践指南、专家共识、系统评价、临床决策、证据总结进行方法学质量评价后,根据研究者专业的临床判断,对符合标准的文献资料进行提取与证据总结。结果共纳入13篇文献,其中1篇指南、2篇专家共识、3篇系统评价、2篇临床决策、5篇证据总结。经整理,分别从专业人员培训、口鼻腔健康的影响因素、鼻腔评估及护理、口腔评估及护理4个方面总结出16条最佳证据。结论本文通过规范的证据汇总制订方法,从4个方面总结出适用于经鼻行管饲实施肠内营养患者的口鼻腔护理相关证据。医护人员应加强对专业人员培训,及早发现成人住院患者经鼻行管饲喂养中影响口鼻腔健康的因素,并根据最佳证据采取有效措施对患者口鼻腔进行评估与护理。Objective To summarizes the evidence of oral and nasal care for adult inpatients during nasal tube feeding and provide reference for clinical implementation.Methods The relevant evidence on oral and nasal care of adult patients with nasal feeding were systematically searched on UpToDate,Joanna Briggs Institute(JBI)Evidence-based Healthcare Center,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Medlive.cn,Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang database and other databases and guideline websites.The retrieval period was from January 1,2016 to August 28,2020.After the methodological quality evaluation of the included clinical practice guidelines,expert consensus,systematic evaluation,clinical decision-making and evidence summary,the literature that met the standards was extracted and the evidence was summarized according to the professional clinical judgment of the researchers.Results A total of 13 literatures were included,including 1 guideline,2 expert consensus,3 systematic evaluation,2 clinical decision making and 5 evidence summaries.After sorting out,16 best evidences were summarized from 4 aspects such as professional training of nursing staff,factors affecting oral and nasal hygiene,assessment and nursing of nasal,assessment and nursing of oral.Conclusions Through the standardized evidence collection and formulation method,this paper summarizes the relevant evidence of oral and nasal nursing for patients with enteral nutrition through nasal tube feeding from 4 aspects.Medical staff should strengthen the training of professionals,find out the factors affecting the oral and nasal health of adult inpatients undergoing nasal tube feeding as soon as possible and take effective measures to evaluate and care the patients'oral and nasal cavity according to the best evidence.

关 键 词：成年人 鼻胃肠管 肠内营养 口腔护理 鼻腔护理 管道护理 

分 类 号：R472[医药卫生—护理学]