慢性肾脏病3~5 D期患者饮食管理最佳证据总结  

Summary of the best evidence for diet management in patients with chronic kidney disease in stage 3-5 D

作　　者：莫露璐 管癸芬[1] 赖晓纯[1] 覃湘君 杨丽君[1] 刘畅[1] 洪东喜 王泽彬[1] 凌冬兰 Mo Lulu;Guan Guifen;Lai Xiaochun;Qin Xiangjun;Yang Lijun;Liu Chang;Hong Dongxi;Wang Zebin;Ling Donglan(Department of Nephrology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;Intensive Care Unit,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;Nursing Department,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院肾内科,广州510260 [2]广州医科大学附属第二医院重症医学科,广州510260 [3]广州医科大学附属第二医院护理部,广州510260

出　　处：《中华现代护理杂志》2022年第16期2152-2161,共10页Chinese Journal of Modern Nursing

基　　金：广州医科大学护理重点专科建设项目(B202002)。

摘　　要：目的总结慢性肾脏病(CKD)3~5 D期患者饮食管理的相关证据,为临床护理工作提供参考。方法确立循证护理问题,按照"6S证据模型",应用计算机系统检索有关CKD 3~5 D期患者饮食管理的相关文献,包括计算机决策支持系统证据、指南、最佳证据总结、系统评价等,检索时限为建库至2020年9月。指南质量评价由2名研究护士及1名肾脏病学博士独立完成,非指南文献的质量评价由2名研究护士独立完成,1名循证导师参与决策。应用Joanna Briggs Institute(JBI)2014版干预性研究证据预分级系统对证据进行证据提取、评价及等级划分。结果共纳入符合要求的文献19篇,其中指南5篇、系统评价8篇,随机对照试验研究4篇、临床决策1篇、国家标准1篇,最终从饮食/营养评估、饮食管理、团队合作与教育3个方面总结出22条CKD 3~5 D期患者饮食管理的最佳证据。结论本研究总结的CKD 3~5 D期患者饮食管理等的最佳证据,为临床实践提供一定参考,以提升慢性肾脏病患者饮食管理质量,改善患者临床结局。Objective To summarize the evidence of diet management in patients with chronic kidney disease(CKD)in stage 3-5 D,so as to provide a reference for clinical nursing.Methods After establishing evidence-based nursing questions,according to the"6S evidence model",the evidence on diet management of patients with CKD in stage 3-5 D was searched by computer,including computer decision support system evidence,guidelines,best evidence summary and systematic review.The search time limit was from the establishment of the database to September 2020.The guideline quality assessment was independently completed by two research nurses and a doctor of nephrology.The quality assessment of non-guideline article was independently completed by two research nurses,and an evidence-based instructor participated in decision-making.The evidence was extracted,evaluated and graded using the Joanna Briggs Institute(JBI)2014 version of the intervention research evidence pre-grading system.Results A total of 19 articles that met the requirements were included,including 5 guidelines,8 systematic reviews,4 randomized controlled trials,1 clinical decision,and 1 national standard.A total of 22 pieces of the best evidence on diet management of patients with CKD in stage 3-5 D were summarized from three aspects,namely,diet/nutrition assessment,diet management,teamwork and education.Conclusions The best evidence of diet management in patients with CKD in stage 3-5 D provides a certain reference for clinical practice,so as to improve the quality of diet management in patients with CKD and the clinical outcomes of patients.

关 键 词：慢性病 慢性肾脏病 饮食管理 证据总结 循证护理 

分 类 号：R473.5[医药卫生—护理学]