新生儿肠内营养胃管留置管理的最佳证据总结

Evidence summary for the management of gastric tube indwelling in neonatal enteral nutrition

目的检索、评价并整合国内外新生儿肠内营养胃管留置管理的相关证据。方法系统检索英国医学杂志最佳临床实践网、Up To Date、CINAHL、加拿大医学会临床实践指南网、国际指南网、WHO指南网、美国国立指南库、医脉通、Cochrane图书馆、PubMed、中国知网、中国生物医学文献数据库、万方数据库、维普等数据库等网站和数据库中关于新生儿肠内营养胃管留置管理的临床决策、推荐实践、证据总结、临床实践指南、技术报告、专家共识、系统评价,由2名研究者独立进行方法学质量评价后,根据主题对证据进行提取与汇总,检索时限为建库至2023年5月。结果共纳入14篇文献,包括指南2篇、证据总结1篇、系统评价5篇、专家共识3篇、最佳实践2篇、随机对照研究1篇。最后总结包括适应与禁忌、置管前的准备与评估、胃管位置验证、胃管固定、胃管维护5个方面的22条证据。结论本研究通过系统检索国内外高级别的循证资源,对新生儿肠内营养胃管留置的管理进行证据总结,所总结的新生儿肠内营养胃管留置管理证据全面、实用,可为规范新生儿胃管留置管理管理提供循证依据,保证新生儿肠内营养安全,提高新生儿护理质量。

Objective To search,evaluate and integrate the relevant evidence of neonatal enteral nutrition and gastric tube indentation management.Methods British Medical Journal Best Clinical Practice Network,Up To Date,CINAHL,Canadian Medical Association Clinical Practice Guidelines Network,International Guidelines Network,WHO guidelines network,National Guidelines Database of the United States,Medive,Cochrane Library were systematically searched by Clinical decisions,recommended practices,evidence summaries,clinical practice guidelines,technical reports,expert consensus,and systematic reviews on neonatal enteral nutrition tube indentation management in websites and databases of libraries,PubMed,CNKI,China Biomedical Literature Database,Wanfang Database and VIP were independently evaluated by two researchers.The evidence was extracted and summarized according to the subject,and the search time was from the establishment of the database to May 2023.Results 14 literatures were included,including 2 guidelines,1 evidence summary,5 systematic reviews,3 expert consensus,2 best practices,and 1 randomized controlled study.The final summary includes 22 pieces of evidence from 5 aspects,including indications and contraindications,preparation and evaluation before catheterization,gastric tube location verification,gastric tube fixation,and gastric tube maintenance.Conclusion By systematically searching high-level evidence-based resources at home and abroad,this study summarized the evidence for the management of neonatal enteral nutrition gastric tube indwelling.The summarized evidence for the management of neonatal enteral nutrition gastric tube indwelling is comprehensive and practical,which could provide evidence-based basis for regulating the management and management of neonatal gastric tube indwelling,ensure the safety of neonatal enteral nutrition and improve the quality of neonatal nursing.