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 ›› 2023, Vol. 4 ›› Issue (3): 269-276.doi: 10.3761/j.issn.2096-7446.2023.03.016

• 证据综合与应用 • 上一篇    下一篇

食管癌术后患者早期经口进食管理的最佳证据总结

贺红, 冯华丽, 徐彩娟, 陈亚红, 徐珏华, 胡妮佳, 景玲玲, 张玉萍, 郑欣欣   

  1. 310009 杭州市 浙江大学医学院附属第二医院胸外科（贺红,胡妮佳）,护理部（冯华丽,徐彩娟,张玉萍,郑欣欣）,肝胆胰外科二病区（陈亚红）,肝胆胰外科五病区（徐珏华）,泌尿外科（景玲玲）
  • 收稿日期:2022-11-07 出版日期:2023-03-10 发布日期:2023-03-07
  • 作者简介:贺红：女,本科,主管护师,护士长,E-mail：zrhh@zju.edu.cn
  • 基金资助:
    浙江省卫生健康科技计划青年创新人才项目（2022RC171）

Summary of the best evidence for the management of early oral feeding in postoperative patients with esophageal cancer

HE Hong, FENG Huali, XU Caijuan, CHEN Yahong, XU Juehua, HU Nijia, JING Lingling, ZHANG Yuping, ZHENG Xinxin   

  • Received:2022-11-07 Online:2023-03-10 Published:2023-03-07

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摘要： 目的 检索并总结食管癌术后患者早期经口进食管理的最佳证据。方法 按照循证“6S”检索证据模型,检索UpToDate、BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家卫生与临床优化研究所、中国知网、万方数据库、中国生物医学文献数据库等数据库及相关网站中有关食管癌术后患者早期经口进食的所有证据,包括临床决策、指南、系统评价、Meta分析、专家共识、证据总结及随机对照试验。检索时限为建库至2022年5月。由2名接受过循证护理系统培训的研究者独立完成文献质量评价,并结合专业人员判断,对符合质量标准的证据进行提取和汇总。结果 最终纳入14篇文献,包括临床决策2篇、指南4篇、专家共识3篇、系统评价 1篇、随机对照试验4篇。从早期经口进食时机选择、吞咽功能评估、进食方案制订、风险识别及预防4个方面汇总24条最佳证据。结论 食管癌术后患者早期经口进食安全可行。护理人员应结合临床情景、应用证据的促进因素和阻碍因素、患者意愿选择最佳证据,为临床提供科学、有循证依据的食管癌术后患者早期经口进食管理方案,从而加速患者术后康复,减少并发症,缩短住院时间。

关键词: 食管肿瘤, 早期经口进食, 手术后医护, 加速康复外科, 循证护理学

Abstract: Objective To retrieve and summarize the relevant evidence of early oral feeding management in patients with esophageal cancer after surgery. Methods According to the evidence-based “6S” model to retrieve the evidence,we searched all the evidence about the management of early oral feeding in postoperative patients with esophageal cancer in UpToDate,BMJ Best Clinical Practice,Australia's Joanna Briggs Institute Evidence-based Practice Database,National Institute for Health and Care Excellence,CNKI,Wanfang Database,China Biomedical Literature Database and related websites or databases,including clinical decisions,guidelines,systematic reviews,meta-analysis,expert consensuses,evidence summaries,and randomized controlled trials. The retrieval time limit was from the establishment of the database to May 2022. The quality of the literature was evaluated independently by two researchers who had received systematic evidence-based nursing training,and the evidence meeting the quality standards was extracted and summarized based on the judgment of professionals. Results 14 literature were eventually included,including two clinical decisions,four guidelines,three expert consensuses,one systematic review and four randomized controlled trials. 24 pieces of best evidence were summarized from 4 aspects of early oral feeding:choice of timing,the evaluation of swallowing function,the formulation of eating plan,risk identification and prevention. Conclusion Early oral feeding is safe and feasible in postoperative patients with esophageal cancer. Nursing staff should select the best evidence based on clinical situation,facilitating factors and barriers of evidence application and patients' willingness,so as to provide scientific and evidence-based management programs for early oral feeding of patients after esophageal cancer surgery,which will accelerate postoperative recovery of patients,reduce complications and shorten hospital stay.

Key words: Esophageal Neoplasms, Early Oral Feeding, Postoperative Care, Enhanced Recovery After Surgery, Evidence-Based Nursing