维持性血液透析患者营养不良管理的最佳证据总结  

A summary of the best evidence for malnutrition management among maintenance hemodialysis patients

作　　者：邹兆华 卿伟[1] 朱茂才[1] 张继权 易子涵 Zou Zhaohua;Qing Wei;Zhu Maocai;Zhang Jiquan;Yi Zihan(Nephrology department,People’s Hospital of Deyang City,Deyang Sichuan,618000,China;Nursing department,People’s Hospital of Deyang City,Deyang Sichuan,618000,China)

机构地区：[1]德阳市人民医院肾内科,四川德阳618000 [2]德阳市人民医院护理部,四川德阳618000

出　　处：《现代临床护理》2024年第6期37-46,共10页Modern Clinical Nursing

基　　金：2021年四川省卫生健康委员会科研课题,项目编号为21PJ173。

摘　　要：目的 检索、评价和总结维持性血液透析(maintenance hemodialysis,MHD)患者营养不良管理的相关证据,为临床医护人员对MHD患者进行营养不良管理提供循证依据。方法 按照证据“6S”金字塔模型,计算机检索UpToDate,BMJ Best Practice,JBI循证卫生保健中心数据库,医脉通,国际指南协作网,美国保健研究和质量机构,英国国家卫生和临床示范研究所,苏格兰学院间指南协作网,加拿大安大略注册护士协会网等指南网;国际肾脏病学会,美国肾脏病基金会,英国肾脏病协会,中华医学会肾脏病学分会,改善全球肾脏病预后组织,国际肾脏营养和代谢学会,美国肠外肠内营养学会,欧洲临床营养和代谢学会,中国营养学会等专业学会与组织机构网站;补充检索PubMed,Web of Science,Embase,Cochrane Library,中国知网,万方数据库,维普数据库,中国生物医学文献数据库等中英文数据库中关于MHD患者营养不良管理的文献,文献类型包括指南、专家共识、临床决策、证据总结、推荐实践、最佳实践、系统评价和临床实践,检索时限为建库至2023年4月10日。2名研究者独立进行文献质量评价、证据提取和整合,采用乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心证据预分级系统进行证据分级。结果 共纳入16篇文献,包括5篇指南、3篇专家共识、1篇临床决策、1篇证据总结、6篇系统评价,从筛查与评估、营养需求、营养补充、其他干预和监测与教育5个方面总结了39条证据。结论 本研究总结的MHD患者营养不良管理的最佳证据具有科学性和系统性,临床医护人员可遵循最佳证据为MHD患者制订个体化营养不良管理方案。Objective To retrieve,evaluate and summarize the relevant evidence on malnutrition management among maintenance hemodialysis(MHD)patients to provide clinical medical staff with evidence-based guidelines for managing malnutrition in MHD patients.Methods Using the“6S”pyramid model of evidence,We searched UpToDate,BMJ best clinical practice,the Australian JBI evidence-based health care centre database(JBI),Medive,the International Guidelines Collaborative Network(GIN),Agency for Healthcare Research and Quality Network,the UK National Institute of Clinical Medicine Guidance Library(NICE),Scottish Inter-College Guide Collaboration network,the Ontario Registered Nurses Association(RNAO),Guidelines Network of International Society of Nephrology,American Nephrology Foundation Guidenet,British Nephrology Society,Society of Nephrology,Chinese Medical Association,Improving Kidney Disease Outcomes Worldwide,International Society of Renal Nutrition and Metabolism,American Society for Parenteral Enteral Nutrition,European Society for Clinical Nutrition and Metabolism,Chinese Nutrition Society,PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang,VIP and CBM,to collect relevant guidelines,expert consensus,clinical decision,evidence summary,recommended practice,best practice,systematic evaluation and clinical practice,from the establishment to the date of April 10th,2023,for literature on malnutrition management of MHD patients.The literature included guidelines,expert consensuses,clinical decision-making studies,evidence summaries,recommended practices,best practices,and systematic reviews.Two researchers independently evaluated,extracted,and integrated the evidence.The evidence was graded by the evidence pre-grading system of the Evidence-based Healthcare Center of Joanna Briggs Institute(JBI).Results A total of 16 articles were included and summarized,comprising 5 guidelines,3 expert consensuses,1 clinical decision-making study,1 evidence summary,and 6 systematic reviews.Thirty-nine pieces of the best evidence were i

关 键 词：维持性血液透析 营养不良 循证护理 最佳证据 

分 类 号：R473.5[医药卫生—护理学]