肝癌患者术后胃肠功能障碍预防和管理的最佳证据总结  

Best evidence summary for the prevention and management of postoperative gastrointestinal dysfunction in patients with liver cancer

作　　者：施晓兰 李鹤[2] 卞丽芳[2] 陈佳萍 李春艳[2] 李琰[2] Shi Xiaolan;Li He;Bian Lifang;Chen Jiaping;Li Chunyan;Li Yan(School of Nursing,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China;Hepatobiliary and Pancreatic Surgery,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang,China)

机构地区：[1]浙江中医药大学护理学院,浙江杭州310053 [2]浙江大学医学院附属第一医院肝胆胰外科,浙江杭州310003

出　　处：《加速康复外科杂志》2024年第4期145-151,共7页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

基　　金：浙大一院院护理学科建设科研项目(2022ZYHL002)。

摘　　要：目的:检索、评价和整合肝癌患者术后胃肠功能障碍预防和管理的最佳证据,为临床护理实践提供参考。方法:按照6S证据金字塔模型,通过计算机系统检索Uptodate、澳大利亚乔安娜布里格斯研究所、Cochrane library、PubMed、Embase、英国国家卫生和临床技术优化研究所、苏格兰校际指南网、美国卫生保健研究与质量局、新西兰指南协作组、中国生物医学文献数据库、中国知网、万方数据库、维普数据库中关于肝癌患者术后胃肠功能障碍预防和管理的指南、临床决策、专家共识、证据总结、系统评价,检索时限为建库至2024年8月31日,由4名研究者独立对相关文献进行质量评价,并对最终纳入文献进行标准化的资料提取。结果:共纳入11篇文献,包括4篇指南、1篇临床决策、2篇系统评价、4篇专家共识。通过文献阅读、证据提取和归类,总结出14条最佳证据。结论:本研究总结了肝癌患者术后胃肠功能障碍预防和管理的最佳证据包括精准评估与分级管理、危险因素预防与干预、治疗与护理,可为医护人员开展临床实践提供参考。医护人员可结合临床环境、患者意愿和患者个体差异等,审慎地选择和应用证据,促进肝癌患者术后胃肠功能的恢复。Objective:To retrieve,evaluate and summarize the current evidence for the prevention and management of postoperative gastrointestinal dysfunction in patients with liver cancer resection,and provide reference for clinical healthcare providers.Method:According to the 6S evidence pyramid,a systematic search was conducted on UpToDate,Australia Joanna Briggs Institute(JBI),Cochrane library,PubMed,Embase,National Institute for Health and Clinical Excellence(NICE),Scottish Intercollegiate Guidelines Network(SIGN),the Agency for Healthcare Research and Quality(AHRQ),New Zealand Guidelines Group(NZGG),China Biomedical Literature Database,China National Knowledge Infrastructure(CNKI),Wanfang Database and the VIP database(VIP)for all the evidence related to the prevention and management of postoperative gastrointestinal dysfunction in patients with liver cancer,including guidelines,clinical decision-making,expert consensus,evidence summary and systematic reviews.The search period was from the establishment of the database to August 31,2024.four researchers independently evaluated the quality of relevant literatures,and standardized data extraction was carried out for the final included literatures.Result:A total of 11 articles were included,including 4 guidelines,1 clinical decision,2 systematic reviews and 4 expert consensus.Through literature reading,evidence extraction and classification,14 pieces of best evidence were summarized.Conclusion:This study summarizes the best evidence for the prevention and management of postoperative gastrointestinal dysfunction in patients with liver cancer,which can provide reference for medical staff to carry out clinical practice,including accurate assessment and graded management,risk factor prevention and intervention,treatment and care.According to the clinical environment,the patient's willingness and individual differences,medical staff can carefully select and apply evidence to promote the recovery of postoperative gastrointestinal function in patients with liver cancer.

关 键 词：肝癌 术后胃肠功能障碍 证据总结 循证护理学 

分 类 号：R473.6[医药卫生—护理学]