肠内营养患者机械性并发症预防及管理的最佳证据总结  

Summary of best evidence on prevention and management of mechanical complications in patients receiving enteral nutrition

作　　者：胡燕 胡敏[2] 李冬英[3] 凌颜 孙迟[5] 毛珍珠 熊芳婷 Hu Yan;Hu Min;Li Dongying;Ling Yan;Sun Chi;Mao Zhenzhu;Xiong Fangting(Wound and Stoma Outpatient Service,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Nursing,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Intensive Care Units,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Neurology,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Neurosurgery,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院伤口造口门诊,南昌330006 [2]南昌大学第二附属医院护理部,南昌330006 [3]南昌大学第二附属医院重症医学科,南昌330006 [4]南昌大学第二附属医院神经内科,南昌330006 [5]南昌大学第二附属医院神经外科,南昌330006

出　　处：《中华现代护理杂志》2023年第11期1477-1482,共6页Chinese Journal of Modern Nursing

基　　金：中华医学会杂志社2021—2022年护理学科研究课题(CMAPH-NRI2021051)。

摘　　要：目的检索肠内营养患者机械性并发症预防及管理的相关证据,并对证据进行总结。方法系统检索Cochrane Library、PubMed、美国临床指南网、英国国家卫生与临床优化研究所、美国肠外肠内营养学会、中国知网、万方数据库、中国生物医学文献数据库等,检索时限为建库至2022年3月20日。采用澳大利亚乔安娜布里格斯研究所(JBI)循证卫生保健中心的文献评价标准和证据分级系统进行文献的质量评级和证据的评估与汇总。结果共纳入13篇文献,包括指南4篇、专家共识4篇、证据总结4篇、病例对照研究1篇,最终从发生原因、预防管理、妥善固定、定时冲洗、合理输注营养液/用药、并发症处理—堵管、并发症处理—黏膜受损、并发症处理—非计划性拔管8个方面形成31条最佳证据。结论医护人员可应用最佳证据构建并开展肠内营养患者机械性并发症预防及管理方案,提高肠内营养患者机械性并发症管理的科学性,改善患者的生存质量和疾病预后。Objective To search for evidence related to the prevention and management of mechanical complications in patients receiving enteral nutrition and to summarize the evidence.Methods The evidence published up to March 20,2022 was systematically retrieved from Cochrane Library,PubMed,American Clinical Guidelines Network,National Institute for Health and Care Excellence,American Society for Parenteral and Enteral Nutrition,CNKI,WanFang Data,SinoMed,etc.The literature evaluation standards and evidence grading system of the Joanna Briggs Institute(JBI)Evidence-Based Health Care Center in Australia were used to rate the quality of the literature,evaluate and summarize the evidence.Result A total of 13 articles were included,including 4 guidelines,4 expert consensuses,4 evidence summaries,and 1 case-control study.Totally 31 best evidences were formed from 8 aspects:causes of occurrence,prevention and management,proper immobilization,regular flushing,reasonable infusion of nutrient solution/medication,treatment of complications-blockage,treatment of complications-mucosal damage,and treatment of complications-unplanned extubation.Conclusions Medical and nursing staff can use the best evidence to develop and implement prevention and management programs for mechanical complications in patients receiving enteral nutrition,strengthen the scientific management of mechanical complications in these patients,and improve the quality of life and prognosis of patients.

关 键 词：营养支持 肠内营养 机械性并发症 预防 管理 

分 类 号：R459.3[医药卫生—治疗学]