ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (10): 1249-1257.doi: 10.3761/j.issn.2096-7446.2026.10.017

• 证据综合研究 • 上一篇    下一篇

成年危重症患者早期滋养型肠内营养的最佳证据总结及临床决策路径图构建

胡恩慧1(), 潘习2, 徐岚1, 王稚2,*()   

  1. 1 苏州大学附属第一医院护理部 苏州市 215006
    2 苏州大学附属第一医院神经内科 苏州市 215006
  • 收稿日期:2025-10-28 出版日期:2026-10-10 发布日期:2026-10-14
  • 通讯作者: *王稚，E-mail：dodolo412@126.com
  • 作者简介:胡恩慧：女，硕士，护师，E-mail：1542706080@qq.com
    作者贡献声明

    胡恩慧、潘习：选题、证据整合、论文撰写；徐岚、王稚：研究指导、论文修改

  • 基金资助:
    苏州市基础研究试点项目(SSD2025074)

Best evidence summary and clinical decision-making pathway construction of early trophic enteral nutrition in adult critically ill patients

HU Enhui1(), PAN Xi2, XU Lan1, WANG Zhi2,*()   

  1. 1 Department of Nursing， the First Affiliated Hospital of Soochow University， Suzhou 215006， China
    2 Department of Neurology， the First Affiliated Hospital of Soochow University， Suzhou 215006， China
  • Received:2025-10-28 Online:2026-10-10 Published:2026-10-14
  • Contact: *WANG Zhi，E-mail：dodolo412@126.com
  • Supported by:
    Suzhou Basic Research Pilot Project(SSD2025074)

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摘要：

目的 系统检索、评价并整合成年危重症患者早期滋养型肠内营养的最佳证据，并基于此构建临床决策路径图，为临床营养管理提供依据。 方法 依据“6S”模型，系统检索国内外数据库、指南及相关网站，获取有关成年危重症患者早期滋养型肠内营养的临床决策、指南、专家共识及系统评价。检索时限为建库至2025年10月2日。由经过循证培训的研究者完成最佳证据总结，并基于此构建临床决策路径图。 结果 最终纳入21篇文献，包括临床决策1篇、指南8篇、专家共识5篇、系统评价7篇。从风险评估、时机与途径、目标能量与蛋白质、供给速率与方式、监测与管理5方面总结出18条证据，基于证据条目构建了成年危重症患者早期滋养型肠内营养支持临床决策路径图。 结论 该研究整合了成年危重症患者早期滋养型肠内营养的相关证据，并基于此构建临床决策图，为临床实践提供循证参考。建议临床实践转化时结合具体情境，针对性选择应用，保证措施有效落实，以改善患者预后。

关键词: 危重症护理, 肠内营养, 滋养型肠内营养, 循证护理

Abstract:

Objective To systematically retrieve，evaluate and integrate the best evidence for early trophic enteral nutrition in adult critically ill patients，and construct a decision-making pathway based on this evidence，so as to provide a basis for clinical nutrition management. Methods According to the "6S" model，domestic and foreign databases，guidelines and relevant websites were systematically searched to obtain clinical decisions，guidelines，expert consensuses and systematic reviews related to early trophic enteral nutrition in adult critically ill patients. The retrieval time limit was from the establishment of the database to October 2，2025. Researchers trained in evidence-based practice completed the summary of the best evidence，and constructed a clinical decision-making pathway diagram based on the summary. Results A total of 21 literatures were finally included，consisting of 1 clinical decision，8 guidelines，5 expert consensuses and 7 systematic reviews. A total of 18 pieces of evidence were summarized from 5 aspects：risk assessment，timing and route，target energy and protein，delivery rate and mode，as well as monitoring and management. On this basis，a clinical decision-making pathway diagram for early trophic enteral nutrition support in adult critically ill patients was constructed. Conclusion This study integrates the relevant evidence for early trophic enteral nutrition in adult critically ill patients and constructs a clinical decision-making diagram accordingly，which provides an evidence-based reference for clinical practice. It is recommended that clinical practice transformation should be combined with specific scenarios，and targeted selection and application should be carried out to ensure the effective implementation of measures and improve the prognosis of patients.

Key words: Critical Care Nursing, Enteral Nutrition, Trophic Feeding, Evidence-Based Nursing