营养支持病人发生再喂养综合征预测模型的系统评价  

Systematic evaluation of predictive models for refeeding syndrome in patients receiving nutritional support

作　　者：伋可欣 王玲华[2] JI Kexin;WANG Linghua(Zhejiang Chinese Medical University,Zhejiang 310053 China)

机构地区：[1]浙江中医药大学,浙江310053 [2]杭州市红十字会医院

出　　处：《循证护理》2024年第7期1169-1175,共7页Chinese Evidence-Based Nursing

摘　　要：目的:系统评价营养支持病人发生再喂养综合征风险预测模型。方法:计算机检索PubMed、EMbase、CINAHL、Web of Science、中国生物医学文献数据库、中国知网和万方数据库中有关再喂养综合征风险预测模型的研究,检索时限为建库至2023年5月11日。2名研究者独立进行文献检索、筛选与资料提取,采用诊断或预后多因素预测模型研究偏倚风险的评估工具对纳入研究进行偏倚风险和适用性评价。结果:最终纳入10篇文献,包含14个营养支持病人再喂养综合征风险预测模型,模型中已报道的受试者工作特征曲线下面积(AUC)值为0.626~0.950。纳入预测模型中常见预测因子包括年龄、SOFA评分、利尿剂的使用、基线血钾、急性生理与慢性健康状况(APACHEⅡ)评分和蛋白质摄入情况。所有研究的适用性较好,但存在一定的偏倚风险。结论:现有证据表明,目前建立的再喂养综合征预测模型主要针对重症监护室病人,对于风险因素的分析和建模还处于初级阶段。有必要明确再喂养综合征的诊断标准,开展多中心、大样本的研究,并进行内外部的验证。Objective:To systematically evaluate the risk predictive models of refeeding syndrome in patients with nutritional support.Methods:The risk predictive models of refeeding syndrome were searched in PubMed,EMbase,CINAHL,Web of Science,CBM,CNKI and WanFang Database.The retrieval time was from the inception to May 11,2023.Two researchers conducted literature retrieval,screened and data extraction independently,and the bias risk and applicability of the included literature were evaluated by using the evaluation tools of diagnostic or prognostic multivariate predictive models to study bias risk.Results:Finally,10 articles were included,including 14 risk predictive models of refeeding syndrome in patients with nutritional support.The area under the working characteristic curve of the subjects reported in the model was 0.626-0.950.The common predictors of the predictive models included age,SOFA score,diuretic use,baseline serum potassium,APACHEⅡscore and protein intake.The applicability of all studies was good,but there was a certain risk of bias.Conclusion:Current evidence shows that the predictive models of refeeding syndrome is mainly aimed at patients with ICU,and the analysis and modeling of risk factors are still in the primary stage.It is necessary to clarify the diagnostic criteria of refeeding syndrome,carry out multicenter,large sample research,and verify it internally and externally.

关 键 词：再喂养综合征 营养支持 预测模型 风险因素 系统评价 循证护理 

分 类 号：R473[医药卫生—护理学]