胰十二指肠切除术后患者早期经口进食最佳证据总结  

The summary of the best evidence of early oral feeding in patients after pancreaticoduodenectomy

作　　者：王安娇 赵梅[1] 乔晓斐 马瑟琴 王刚[2] 王秀芝 WANG Anjiao;ZHAO Mei;QIAO Xiaofei;MA Seqin;WANG Gang;WANG Xiuzhi(School of Nursing,Anhui Medical University,Hefei 230032,China;Department of Biliary and Pancreatic Surgery,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]安徽医科大学护理学院,合肥市230032 [2]中国科学技术大学附属第一医院胆胰外科,合肥市230001

出　　处：《护理管理杂志》2024年第5期437-443,共7页Journal of Nursing Administration

基　　金：安徽省高校人文社会科学研究项目重大项目(SK2021ZD0030);安徽省自然科学基金面上项目(2308085MH285)。

摘　　要：目的总结胰十二指肠切除术后患者早期经口进食的最佳证据。方法系统检索国内外数据库中关于胰十二指肠切除术后患者早期经口进食相关证据,检索时限为建库至2024年3月5日。由两名研究者对纳入文献进行质量评价、证据提取和总结最终形成最佳证据。结果共纳入12篇文献,包括临床决策1篇、指南3篇、专家共识3篇、系统评价2篇、随机对照试验3篇。总结出胰十二指肠切除术后早期经口进食安全性、营养风险筛查与评估、识别高风险人群、进食推荐方案、目标能量和口服营养补充剂、胰腺内外分泌功能管理和营养监测及处理7个主题,共30条最佳证据。结论胰十二指肠切除术后患者早期经口进食是安全及可行的。胰腺外科工作者应根据临床实际情况,选择性应用最佳证据,为患者提供安全且规范的早期经口进食方案,促进患者康复。Objective To summarize the best evidence of early oral feeding after pancreaticoduodenectomy.Methods Systematic re⁃trieval of domestic and foreign databases related evidence of early oral feeding after pancreaticoduodenectomy,the search deadline was from database establishment to March 5,2024.Two researchers evaluated the quality of the included literature,extracted evidence,and summarized it to form the best evidence.Results Twelve articles were finally included:one clinical decision-making paper,three guidelines,three expert consensuses,two systematic reviews and three randomized controlled trials.A total of 30 pieces of best evidence for early oral feeding after pancreaticoduodenectomy were summarized from 7 aspects:safety,early oral feeding adaptation population,nutritional risk assessment and screening,placement of nutritional pipelines under special circumstances,feeding timing and dietary structure,target energy and oral nutrition⁃al supplements,blood glucose control and pancreatic enzyme substitution therapy and nutritional quality control.Conclusion It is safe and feasible for patients to eat early after pancreatoduodenectomy.Pancreatic surgeons should selectively apply the best evidence according to the actual clinical situation to provide patients with a safe and standardized early oral feeding plan and promote their rehabilitation.

关 键 词：胰十二指肠切除术 早期经口进食 营养支持 证据总结 

分 类 号：R473.5[医药卫生—护理学] R735.31[医药卫生—临床医学]