食管癌术后患者早期经口进食管理的最佳证据总结  

Summary of the best evidence for the management of early oral feeding in postoperative patients with esophageal cancer

作　　者：贺红[1] 冯华丽 徐彩娟[2] 陈亚红[3] 徐珏华[4] 胡妮佳 景玲玲 张玉萍[2] 郑欣欣 HE Hong;FENG Huali;XU Caljuan;CHEN Yahong;XU Juehua;HU Njia;JING Lingling;ZHANG Yuping;ZHENG Xinxin

机构地区：[1]浙江大学医学院附属第二医院胸外科,杭州市310009 [2]浙江大学医学院附属第二医院护理部,杭州市310009 [3]浙江大学医学院附属第二医院肝胆胰外科二病区,杭州市310009 [4]浙江大学医学院附属第二医院肝胆胰外科五病区,杭州市310009 [5]浙江大学医学院附属第二医院泌尿外科,杭州市310009

出　　处：《中华急危重症护理杂志》2023年第3期269-276,共8页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省卫生健康科技计划青年创新人才项目(2022RC171)。

摘　　要：目的检索并总结食管癌术后患者早期经口进食管理的最佳证据。方法按照循证“6S”检索证据模型,检索UpToDate、BMJ Best Practice、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、英国国家卫生与临床优化研究所、中国知网、万方数据库、中国生物医学文献数据库等数据库及相关网站中有关食管癌术后患者早期经口进食的所有证据,包括临床决策、指南、系统评价、Meta分析、专家共识、证据总结及随机对照试验。检索时限为建库至2022年5月。由2名接受过循证护理系统培训的研究者独立完成文献质量评价,并结合专业人员判断,对符合质量标准的证据进行提取和汇总。结果最终纳入14篇文献,包括临床决策2篇、指南4篇、专家共识3篇、系统评价1篇、随机对照试验4篇。从早期经口进食时机选择、吞咽功能评估、进食方案制订、风险识别及预防4个方面汇总24条最佳证据。结论食管癌术后患者早期经口进食安全可行。护理人员应结合临床情景、应用证据的促进因素和阻碍因素、患者意愿选择最佳证据,为临床提供科学、有循证依据的食管癌术后患者早期经口进食管理方案,从而加速患者术后康复,减少并发症,缩短住院时间。Objective To retrieve and summarize the relevant evidence of early oral feeding management in pa-tients with esophageal cancer after surgery.Methods According to the evidence-based"6s"model to retrieve theevidence,we searched all the evidence about the management of early oral feeding in postoperative patients with esophageal cancer in UpToDate,BMJ Best Clinical Practice,Australia's Joanna Briggs Institute Evidence-based Prac-tice Database,National Institute for Health and Care Excellence,CNKI,Wanfang Database,China Biomedical Litera-ture Database and related websites or databases,including clinical decisions,guidelines,systematic reviews,meta-analysis,expert consensuses,evidence summaries,and randomized controlled trials.The retrieval time limit was from the establishment of the database to May 2022.The quality of the literature was evaluated independently by two researchers who had received systematic evidence-based nursing training,and the evidence meeting the quality standards was extracted and summarized based on the judgment of professionals.Results 14 literature were even-l tually included,including two clinical decisions,four guidelines,three expert consensuses,one systernatic review andl four randomized controlled trials.24 pieces of best evidence were summarized from 4 aspeets of early oral feeding:choice of timing,the evaluation of swallowing function,the formulation of eating plan,risk identification and preven-l tion.Conclusion Early oral feeding is safe and feasible in postoperative patients with esophageal caneer.Nursing staff should seleet the best evidence based on elinical situation,facilitating factors and barriers of evidenee applica-l tion and patients'willingness,so as to provide scientifie and evidenee-based management programs for early oral feeding of patients after esophageal cancer surgery,which will accelenate postoperative recovery of patients,redueel complications and shorten hospital stay.

关 键 词：食管肿瘤 早期经口进食 手术后医护 加速康复外科 循证护理学 

分 类 号：R473.73[医药卫生—护理学]