胃肿瘤切除术后患者居家口服营养支持的最佳证据总结

doi:10.16460/j.issn1008-9969.2023.20.024

摘要/Abstract

摘要： 目的总结胃肿瘤切除术后患者居家口服营养管理的最佳证据,为医护人员进行出院饮食指导提供依据。方法根据“6 S”证据模型,系统检索国内外中英文数据库及相关专业网站,检索时限为建库至2023年6月。由2名研究者独立完成文献质量评价、证据提取和整合。结果共纳入相关文献19篇,其中临床决策3篇,指南4篇,系统评价2篇,随机对照试验6篇,专家共识4篇。最终形成包括居家口服营养支持建议、进食障碍管理、营养监测的内容及频率、医务人员职责4个方面,共30条证据。结论本研究从4个方面总结了当前胃肿瘤切除术后患者居家经口营养支持的证据,旨在通过提升患者肿瘤营养素养、促进患者主动参与饮食管理,进而提升患者经口摄入量,达到维持体质量、改善营养状况的目的。同时总结了医务人员在患者营养管理中的责任与义务,尤其是在长期营养教育和饮食随访中的作用。

关键词: 胃肿瘤, 切除术, 口服营养支持, 居家自我管理, 循证护理

Abstract: Objective To summarize the best evidence for oral nutrition support at home in patients after gastrectomy, and to provide reference for medical staff to provide dietary guidance after discharge. Methods According to the “6S” evidence model, domestic and foreign databases and professional websites were systematically searched. Then the quality of the eligible literature was evaluated by two researchers independently. The retrieval period was from the inception of the databases to June 2023. Results A total of 19 articles were included, including 3 clinical decision-makings, 4 guidelines, 2 systematic reviews, 6 RCTs and 4 expert consensus. Thirty pieces of evidence were summarized into four aspects, including home oral nutrition support recommendations, eating disorder management, content and frequency of nutrition monitoring, and the responsibilities of medical staff. Conclusion This study summarizes the evidence of home oral nutritional support for patients after gastrectomy from four aspects. It helps to improve patients’ tumor nutrition literacy, and their active participation in dietary management, and ultimately increase their oral intake, achieving the goal of maintaining weight and improving nutritional status. Meanwhile, medical staff’s responsibilities and obligations in patient nutrition management were summarized, especially their role in long-term nutrition education and dietary follow-up.

Key words: gastric tumor, gastrectomy, oral nutritional support, self-management at home, evidence-based care

中图分类号:

R473.73

白雪洁, 刘丽萍, 张星星, 温海飞, 甄莉. 胃肿瘤切除术后患者居家口服营养支持的最佳证据总结[J]. 护理学报, 2023, 30(20): 24-30.

BAI Xue-jie, LIU Li-ping, ZHANG Xing-xing, WEN Hai-fei, ZHEN Li. Best evidence summary for home oral nutritional support in patients after gastrectomy[J]. Journal of Nursing, 2023, 30(20): 24-30.

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