老年痴呆患者使用口服营养补充剂的最佳证据总结  

Summary of the optimal evidence for oral nutritional supplement use in patients with senile dementia

作　　者：苏予洁 马丽[1] 谢琪 南锐伶[2] 王兴蕾 豆欣蔓[1,3] SU Yujie;MA Li;XIE Qi;NAN Ruiling;WANG Xinglei;DOU Xinman(Nursing School,Lanzhou University,Lanzhou 730011,Gansu,China;Department of Critical Care Medicine,Lanzhou University Second Hospital,Lanzhou 730030,Gansu,China;Department of Nursing,Lanzhou University Second Hospital,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州大学护理学院,甘肃省兰州市730011 [2]兰州大学第二医院重症医学科,甘肃省兰州市730030 [3]兰州大学第二医院护理部,甘肃省兰州市730030

出　　处：《广西医学》2023年第2期192-198,211,共8页Guangxi Medical Journal

基　　金：甘肃省教育科技创新科研项目(2022QB-008);甘肃省卫生健康行业科研项目(GSWSHL2021-011);兰州大学第二医院萃英科技计划项目(CY2020-MS19);甘肃省科技计划重点研发项目(20YF8FA077)。

摘　　要：目的对老年痴呆患者使用口服营养补充剂(ONS)的最佳证据进行评价及总结。方法以循证“6S”证据模型为基础,通过计算机检索UpToDate数据库、BMJ Best Practice数据库、国际实践指南注册平台网站、英国卫生与临床优化研究所网站、国际指南网、加拿大安大略注册护士协会网、苏格兰学院间指南网、欧洲肠内肠外营养协会网、美国肠内肠外营养协会网、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、Cochrane Library数据库、PubMed数据库、中国生物医学文献数据库中有关老年痴呆患者使用ONS的相关证据,包括临床指南、临床决策、证据总结、系统评价、专家共识和意见、随机对照试验。进行文献质量评价后,提取相关证据,并确定证据分级和推荐级别。结果共纳入12篇文献,包括证据总结1篇、临床指南2篇、系统评价7篇、随机对照试验2篇,总结涉及老年痴呆患者营养风险筛查与评估、ONS的使用原则、ONS的使用方法、ONS制剂的选择、使用ONS的依从性、ONS的应用效果评估方法、ONS的疗效与评价7个方面共19条最佳证据,其中A级推荐证据11条(57.9%)。结论总结老年痴呆患者使用ONS的最佳证据,可为营养不良或存在营养不良风险的老年痴呆患者的营养支持干预提供科学可靠的循证依据。Objective To evaluate and summarize the optimal evidence for oral nutritional supplement(ONS)use on patients with senile dementia.Methods Based on evidence-based"6S"evidence model,related evidences associated with ONS use in patients with senile dementia,including clinical guidelines,clinical decisions,evidence summaries,systematic evaluation,expert consensus and opinions,and randomized controlled trials,were retrieved by computer from UpToDate database,BMJ Best Practice database,Practice Guideline REgistration for transPAREncy website,National Institute for Health and Care Excellence website,Guidelines International Network,Registered Nurses′Association of Ontario website,Scottish Intercollegiate Guidelines Network,European Society for Parenteral and Enteral Nutrition network,American Society for Parenteral and Enteral Nutrition network,Joanna Briggs Institute database,Cochrane Library database,PubMed database,and China Biology Medicine,and then related evidences were extracted after the performance of literature quality evaluation,and the evidence classification and recommendation level were determined.Results A total of 12 literature was enrolled,including 1 article of evidence summary,2 articles of clinical guidelines,7 articles of systematic evaluations,and 2 articles of randomized controlled trials.A total of 19 optimal evidences were summarized in 7 perspectives concerning screening and evaluation of nutritional risk in patients with senile dementia,principle of ONS use,methods of ONS use,selection of ONS preparations,compliance of ONS use,evaluation method of ONS application effect,efficacy and evaluation of ONS,therein there were 11(57.9%)recommended evidences with grade A.Conclusion Summary of the optimal evidences for ONS use in patients with senile dementia can provide scientific and reliable evidence-based basis for nutritional support and intervention in senile dementia patients with malnutrition or risk of malnutrition.

关 键 词：老年痴呆 口服营养补充剂 最佳证据 营养不良 营养支持 循证医学 

分 类 号：R592[医药卫生—老年医学]