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
重症营养支持护理专题

急性肠系膜缺血患者营养支持的范围综述

  • 向波 ,
  • 刘丽萍 ,
  • 黄萍
展开
  • 400016 重庆市 重庆医科大学附属第一医院血管外科
向波:女,本科(硕士在读),护师,E-mail:970870656@qq.com

收稿日期: 2022-09-26

  网络出版日期: 2023-02-09

基金资助

重庆医科大学附属第一医院护理科研基金(HLJJ2015-19)

Nutritional support in patients with acute mesenteric ischemia: a scoping review

  • XIANG Bo ,
  • LIU Liping ,
  • HUANG Ping
Expand

Received date: 2022-09-26

  Online published: 2023-02-09

摘要

目的 对急性肠系膜缺血患者的营养支持进行范围综述,分析其营养支持方式、途径、时间、配方及结局评价指标,为临床实践及后期研究提供参考。方法 采用Arksey等提出、Levac等细化的范围综述方法框架,检索中国知网、中国生物医学文献数据库、维普中文科技期刊数据库、万方数据库、Cochrane Library、PubMed、Elsevier数据库中相关研究,检索时间为建库至2022年10月。对纳入文献进行筛选、汇总和分析。结果 共纳入10篇文献,其中中文4篇、英文6篇,发表时间为1974年—2020年,分析总结了营养支持方式及途径、肠外营养配方、肠内营养启动时间及评估指标、肠内营养配方和结局评价指标。结论 营养支持改善了急性肠系膜缺血患者临床结局,但缺乏营养风险筛查、早期肠内营养支持及出院后营养随访方面的研究,未来需开展更多研究探讨营养支持在急性肠系膜缺血患者中的运用,从而形成规范及指南。

本文引用格式

向波 , 刘丽萍 , 黄萍 . 急性肠系膜缺血患者营养支持的范围综述[J]. 中华急危重症护理杂志, 2023 , 4(2) : 119 -124 . DOI: 10.3761/j.issn.2096-7446.2023.02.004

Abstract

Objective To perform a scoping review on nutritional support in patients with acute mesenteric ischemia,describe the mode,approach,time,formula and outcome evaluation index of nutritional support in order to provide reference for clinical work and later research. Methods A literature search was performed in the CNKI,CBM,VIP,Wanfang,Cochrane Library,PubMed,Elsevier databases to identify relevant studies following the framework of scoping review which was proposed by Arksey et al. and refined by Levac et al. The time was from the establishment of the database to October 2022. The included literature was screened,summarized and analyzed. Results A total of 10 articles were included,including 4 in Chinese and 6 in English,published from 1974 to 2020. The methods and approaches of nutritional support,parenteral nutrition formula,enteral nutrition initiation time and evaluation indexes,enteral nutrition formula and outcome evaluation indexes were analyzed and summarized. Conclusion Nutritional support improves the clinical outcome of patients with acute mesenteric ischemia,but there is a lack of research on nutrition screening,early enteral nutrition support and nutritional follow-up after discharge. In the future,more studies need to be carried out to explore the application of nutritional support in patients with acute mesenteric ischemia to form norms and guidelines.

参考文献

[1] Tilsed JT,Casamassima A,Kurihara H,et al.ESTES guidelines:acute mesenteric ischaemia[J]. Eur J Trauma Emerg Surg,2016, 42(2):253-270.
[2] Bala M,Catena F,Kashuk J,et al.Acute mesenteric ischemia:updated guidelines of the World Society of Emergency Surgery[J]. World J Emerg Surg,2022,17(1):54.
[3] Reintam Blaser A,Forbes A,Björck M.Acute mesenteric ischaemia[J]. Curr Opin Crit Care,2022,28(6):702-708.
[4] Savlania A,Tripathi RK.Acute mesenteric ischemia:current mul-tidisciplinary approach[J]. J Cardiovasc Surg(Torino),2017,58(2):339-350.
[5] Arksey H,O'Malley L. Scoping studies:towards a methodological framework[J]. Int J Soc Res Methodol,2005,8(1):19-32.
[6] Levac D,Colquhoun H,O'Brien KK. Scoping studies:advancing the methodology[J]. Implement Sci,2010,5:69.
[7] 吴庆华,韩延民,杨宝钟,等. 急性肠系膜上动脉栓塞小肠广泛坏死七例治疗经验[J]. 中华普通外科杂志,2001,16(12):725-727.
Wu QH,Han YM,Yang BZ,et al.Experience in the management of extensive small bowel necrosis from acute superior mesenteric arterial embolism:report of 7 cases[J]. Chin J Gen Surg,2001,16(12):725-727.
[8] 韩建明,李为苏,吴性江,等. 肠康复治疗用于缺血性肠功能障碍[J]. 肠外与肠内营养,2004,11(4):209-211,215.
Han JM,Li WS,Wu XJ,et al.Bowel nutritional rehabilitation therapy for gut dysfunction after acute mesenteric artery ischemia[J]. Parenter & Enter Nutr,2004,11(4):209-211,215.
[9] 王凯,李幼生,王剑,等. 急性肠系膜血管缺血早期确定性手术后病人的营养支持[J]. 肠外与肠内营养,2011,18(2):75-78.
Wang K,Li YS,Wang J,et al.Nutritional support after early definitive operation in acute mesenteric ischemia[J]. Parenter & Enter Nutr,2011,18(2):75-78.
[10] 刘宝晨,丁威威,范欣鑫,等. 一例急性肠系膜上动脉栓塞的营养支持治疗[J]. 肠外与肠内营养,2018,25(3):188-192.
Liu BC,Ding WW,Fan XX,et al.Nutritional support for a case of acute superior mesenteric artery embolism[J]. Parenter & Enter Nutr,2018,25(3):188-192.
[11] Gusberg R,Gump FE.Combined surgical and nutritional management of patients with acute mesenteric vascular occlusion[J]. Ann Surg,1974,179(3):358-361.
[12] Gawenda M,Walter M.Long-term parenteral nutrition in vas-cular-induced short bowel syndrome[J]. Langenbecks Arch Chir,1996,381(1):42-45.
[13] Gatt M,MacFie J,Anderson AD,et al. Changes in superior me-senteric artery blood flow after oral,enteral,and parenteral feeding in humans[J]. Crit Care Med,2009,37(1):171-176.
[14] Imran S,Tanweer A.Postoperative nutritional support of the patient with gut gangrene-a case report[J]. J Health Popul Nutr,2019,38(1):11.
[15] Yang SF,Guo JM,Ni QH,et al.Enteral nutrition improves clinical outcome and reduces costs of acute mesenteric ischaemia after recanalisation in the intensive care unit[J]. Clin Nutr,2019,38(1):398-406.
[16] El-Helou E,Alimoradi M,Sabra H,et al.Adult patient living 32 years with postduodenal remnant small bowel of only 35 cm in jejunocolic anastomosis type II weaned off parenteral nutrition. A case report[J]. Int J Surg Case Rep,2020,74:148-151.
[17] 于康,孙文彦. 护理人员在营养风险筛查中的作用[J]. 中国护理管理,2020,20(3):324-327.
Yu K,Sun WY.The role of nurses in nutritional risk screening[J]. Chin Nurs Manag,2020,20(3):324-327.
[18] 杨剑,张明,蒋朱明,等. 营养筛查与营养评定:理念、临床实用及误区[J]. 中华临床营养杂志,2017,25(1):59-64.
Yang J,Zhang M,Jiang ZM,et al.Nutritional risk screening and nutritional assessment:definition,clinical practice,and possible pitfalls[J]. Chin J Clin Nutr,2017,25(1):59-64.
[19] 许静涌,杨剑,康维明,等. 营养风险及营养风险筛查工具营养风险筛查2002临床应用专家共识(2018版)[J]. 中华临床营养杂志,2018,26(3):131-135.
Xu JY,Yang J,Kang WM,et al.Nutrition risk and nutrition risk screening tool expert consensus on clinical application of nutrition risk screening in 2002(2018 edition)[J]. Chin J Clin Nutr,2018,26(3):131-135.
[20] Compher C,Bingham AL,McCall M,et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient:the American Society for Parenteral and Enteral Nutrition[J]. JPEN J Parenter Enteral Nutr,2022,46(1):12-41.
[21] 中华医学会肠外肠内营养学分会,营养风险-不足-支持-结局-成本/效果多中心协作组,张献娜,等. 营养风险筛查和全球(营养)领导人发起的营养不良诊断(GLIM)第二、三步流程(共识2020). 中华临床营养杂志,2020,28(04):193-200.
Chinese Society for Parenteral,Enteral Nutrition(CSPEN)-Nutritional risk-Undernutrition-Support-Outcome-Cost/effectiveness(NUSOC),Zhang XN,et al. Nutritional risk screening and GLIM steps 2 and 3 for the diagnosis of malnutrition and severity of malnutrition(Consensus 2020)[J]. Chin J Clin Nutr,2020,28(4):193-200.
[22] Sánchez-Rodríguez D,Marco E,Ronquillo-Moreno N,et al.ASPEN-AND-ESPEN:a postacute-care comparison of the basic definition of malnutrition from the American Society of Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics with the European Society for Clinical Nutrition and Metabolism definition[J]. Clin Nutr,2019,38(1):297-302.
[23] Reintam Blaser A,Starkopf J,Alhazzani W,et al.Early enteral nutrition in critically ill patients:ESICM clinical practice guidelines[J]. Intensive Care Med,2017,43(3):380-398.
[24] Pironi L,Boeykens K,Bozzetti F,et al.ESPEN guideline on home parenteral nutrition[J]. Clin Nutr,2020,39(6):1645-1666.
[25] Cuerda C,Pironi L,Arends J,et al.ESPEN practical guideline:clinical nutrition in chronic intestinal failure[J]. Clin Nutr,2021,40(9):5196-5220.
[26] 丛明华. 肠外营养安全性管理中国专家共识[J]. 肿瘤代谢与营养电子杂志,2021,8(5):495-502.
Cong MH.Chinese expert consensus on the safety of parenteral nutrition[J]. Electron J Metab Nutr Cancer,2021,8(5):495-502.
[27] 中华医学会肠外肠内营养学分会老年营养支持学组. 中国老年患者肠外肠内营养应用指南(2020)[J]. 中华老年医学杂志,2020,39(2):119-132.
Geriatric Nutrition Support Group,Society of Parenteral and Enteral Nutrition,Chinese Medical Association. Guidelines for the application of parenteral and enteral nutrition in elderly Chinese[J]. Chin J Geriatr,2020,39(2):119-132.
[28] 栾晶晶,纪强,刘珊珊,等. 肠内营养制剂临床应用进展[J]. 中国新药与临床杂志,2018,37(12):665-670.
Luan JJ,Ji Q,Liu SS,et al.Progress in clinical application of enteral nutrition preparations[J]. Chin J New Drugs Clin Re-medies,2018,37(12):665-670.
[29] 孙岩波,陈永平,李树民,等. 谷氨酰胺联合益生菌对腹部大手术后病人早期肠屏障损伤及细菌易位的影响[J]. 肠外与肠内营养,2020,27(5):265-269.
Sun YB,Chen YP,Li SM,et al.Effects of glutamine combined with probiotics on intestinal mucosal barrier and bacterial translocation after major abdominal surgery[J]. Parenter & Enter Nutr,2020,27(5):265-269.
[30] 程伟鹤,鲁梅珊,郭海凌,等. 危重症患者早期肠内营养喂养不耐受的研究进展[J]. 中华护理杂志,2017,52(1):98-102.
Cheng WH,Lu MS,Guo HL,et al.Research progress on early enteral feeding intolerance in critically ill patients[J]. Chin J Nurs,2017,52(1):98-102.
文章导航

/