肝移植受者围手术期营养支持的最佳证据总结

doi:10.3761/j.issn.2096-7446.2024.06.015

摘要/Abstract

摘要： 目的系统检索肝移植受者围手术期营养管理相关研究,总结最佳证据。方法按照循证资源“6S”模型自上向下检索BMJ最佳临床实践、UpToDate等源数据库,纳入截至2023年4月内容涉及肝移植受者围手术期营养支持的研究,包括临床决策、证据总结、指南、专家共识、系统评价类型的中英文相关文献,由2名研究者通过文献筛选和质量评价确定最终纳入文献,最后进行证据内容的提取与总结。结果共纳入文献12篇,包括临床决策1篇、指南4篇、专家共识4篇、Meta分析3篇。汇总了建立多学科团队、营养筛查与评估、术前营养摄入目标和种类、术后营养摄入目标及种类、术后营养摄入开始时间、营养支持方式及要求、定期随访7个主题、30条证据。结论临床实践中可根据循证医学证据制订肝移植受者围手术期营养支持的相关规范,在实践中根据受者具体情况给予营养支持,保证肝移植受者围手术期营养需求的满足。

关键词: 肝移植, 围手术期, 营养支持, 证据总结, 循证护理学

Abstract: Objective To systematically search the related research on perioperative nutrition management of liver transplant recipients and summarize the best evidence. Methods According to the "6S" model of evidence-based resources,BMJ best practice,UpToDate and other source databases were searched from top to bottom,and the research on perioperative nutrition management of liver transplant recipients was included up to April 2023,including Chinese and English related literatures on clinical decision-making,evidence summary,guidelines,expert consensus and systematic reviews. Two researchers conducted independent screening and quality evaluation of the related literatures to include the literature finally,and extracted summarized the evidence. Results A total of 12 literature were included,including 1 clinical decision,4 guidelines,4 expert consensuses and 3 meta-analyses. Thirty pieces of evidence were summarized,which were categorized to seven aspects：establishment of multidisciplinary team,nutrition screening and evaluation,preoperative nutrition intake goals and types,postoperative nutrition intake goals and types,postoperative nutrition intake starting time,nutrition support methods and requirements,and follow-up. Conclusion In clinical practice,the relevant norms of perioperative nutritional support for liver transplant recipients can be formulated according to evidence,and nutritional support can be given according to the specific situation of recipients in practice to ensure that the perioperative nutritional needs of liver transplant recipients can be met.

Key words: Liver Transplantation, Perioperative, Nutrition Support, Evidence Summary, Evidence-Based Nursing

李天姿, 张慧芳, 黄月华, 莫红平, 蔡敏, 邱逸红. 肝移植受者围手术期营养支持的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(6): 562-569.

LI Tianzi, ZHANG Huifang, HUANG Yuehua, MO Hongping, CAI Min, QIU Yihong. Summary of the best evidence of perioperative nutritional support for liver transplant recipients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(6): 562-569.

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