甲状腺癌术后乳糜漏预防和管理的最佳证据总结  

Summary of the best evidence for the prevention and management of chyle leak after thyroid cancer surgery

作　　者：梁美[1] 张令鸣 许腾 王露 翟珊珊 尹丽娟 Liang Mei;Zhang Lingming;Xu Teng;Wang Lu;Zhai Shanshan;Yin Lijuan(Department of Thyroid Surgery,Affiliated Hospital of Jining Medical College,Jining 272000,China;Department of Gastroenterology,Affiliated Hospital of Jining Medical College,Jining 272000,China)

机构地区：[1]济宁医学院附属医院甲状腺外科,济宁272000 [2]济宁医学院附属医院消化内科,济宁272000

出　　处：《中国实用护理杂志》2025年第11期849-858,共10页Chinese Journal of Practical Nursing

基　　金：山东省医药卫生科技项目(202304010411)。

摘　　要：目的检索、获取国内外甲状腺癌术后乳糜漏预防和管理的相关证据进行总结,为临床实践工作提供参考。方法基于“6S”金字塔模型系统检索UpToDate、BMJ最佳临床实践、国际指南协作网、美国国立指南数据库、PubMed、EMbase、万方数据库、中国知网等数据库中关于甲状腺癌术后乳糜漏预防和管理相关的指南、专家共识、系统评价、证据总结、临床决策、立场声明,检索时限为建库至2024年6月1日。结果共纳入16篇文献,包括指南5篇,专家共识9篇,系统评价2篇,从术前评估与准备、术中预防、诊断、饮食及营养管理、监测与治疗、健康教育6个方面汇总了30条最佳证据。结论该研究通过对相关证据进行汇总,为医护人员制订甲状腺癌术后乳糜漏的干预措施和管理方案提供借鉴。Objective To retrieve and obtain relevant evidence at home and abroad on the prevention and management of chylous leakage after thyroid cancer surgery,and provide reference for clinical practice.Methods Based on the 6S pyramid model system,evidence related to the prevention and management of chylous leakage after thyroid cancer surgery in the databases of UpToDate,BMJ best practice,Guidelines International Network(GIN),National Guideline Clearinghouse(NGC),PubMed,EMbase,Wanfang Database,China National Knowledge Infrastructure(CNKI)and other databases,including guidelines,expert consensus,systematic reviews,evidence summary,clinical decisions,and position statements.The retrieval time was from database establishment to June Ist 2024.Results A total of 16 articles were included,including 5 guidelines,9 expert consensus,and 2 systematic reviews.The 30 best pieces of evidence were summarized from 6 aspects:preoperative evaluation and preparation,intraoperative prevention,diagnosis,diet and nutrition management,monitoring and treatment,and health education.Conclusions This study summarized relevant evidence and provides reference for medical staff to formulate intervention measures and management plans for chyle leakage after thyroid cancer surgery.

关 键 词：甲状腺肿瘤 乳糜漏 管理 预防 证据总结 

分 类 号：R736.1[医药卫生—肿瘤] R473.73[医药卫生—临床医学]