住院患儿营养风险筛查的证据报告

Evidence Report of Nutritional Risk Screening of Hospitalized Children

目的评价总结住院患儿营养风险筛查最佳证据。方法计算机检索Cochrane图书馆、JBI循证卫生保健国际合作中心图书馆、加拿大临床实践指南数据库、美国指南网、EBM reviews、Nursing consult、Pub Med、Embase、中国生物医学文献数据库及中国知网内关于住院患儿营养风险筛查的所有指南、系统评价及诊断性研究。由2名研究者分别对文献质量进行评价和资料提取并对符合质量标准的文献进行证据提取。结果共纳入7篇文献,其中以专家共识为基础指南1篇,系统评价2篇和诊断性研究4篇。建议医疗机构根据证据要求对住院患儿进行营养风险筛查。营养状态和生长发育风险筛查工具更容易实施,其敏感度为80%,特异度为49%,且其筛选高风险患儿的特异性更高;约克郡儿科营养不良筛查工具筛检低风险患儿的敏感性更低。结论营养状态和生长发育风险筛查工具用于住院患儿营养风险筛查时易于实施,敏感度高,对评估者无特殊要求,较适于临床应用。

Objective To explore the best evidence of nutritional risk screening of hospitalized children. Methods We conducted literature review in Cochrane Library, JBI library, Canadian Clinical Practice Guidelines Online, EBM reviews, Nursing consult, PubMed, Embase, Sinomed and CNKI for literatures on basic guideline, systematic reviews and diagnostic studies of nutritional risk screening of hospitalized children and the studies were critically appraised by two reviewers. Then the data of included studies were extracted. Results Seven studies were included with 1 study of basic guideline, 2 studies on systematic review and 4 diagnostic studies. It is supposed to conduct nutritional risk screening based on evidence requirement. With sensitivity of 80% and specificity of 49%, Screening Tool for Risk on Nutritional status and Growth, （STRONGkids） was suitable for screening children with high risk but The Paediatric Yorkhill Malnutrition Score （PYMS） was with low sensitivity when used in screening children with low risk. Conclusion With high sensitivity, STRONGkids is a suitable tool for screening nutritional risk of hospitalized children in clinic.