以口服营养补充剂为主的老年髋部骨折患者营养方案的构建

Construction of a nutritional regimen based on oral nutritional supplements for elderly patients with hip fractures

目的构建老年髋部骨折患者围手术期及康复期营养干预方案。方法以Stetler循证实践模式为理论依据,对2019年1-5月上海健康医学院附属嘉定区中心医院收治的151例老年髋部骨折手术患者进行调查,探讨其围手术期及术后3个月存在的营养问题。通过系统检索文献,提取最佳证据,构建以口服营养补充剂(oral nutrition supplements,ONS)为主的老年髋部骨折患者营养干预方案。采用专家会议法对方案进行论证,确定最终干预方案及流程。结果纳入指南7篇,提取证据并形成推荐意见25条,其中24条强推荐,1条弱推荐。确定了以ONS为主的老年髋部骨折患者营养干预方案及流程,专家权威系数为0.89.结论本研究构建的以ONS为主的老年髋部骨折患者营养干预方案专家权威程度高,结果可信,为临床开展老年髋部骨折患者围手术期营养干预提供了理论依据。

Objective To construct the nutritional intervention regimen for elderly patients with hip fractures during the perioperative period and rehabilitation period.Methods Based on Stetler evidence-based practice model,151 elderly patients with hip fractures surgery who were admitted to Jiading District Central Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January to May 2019 were investigated,and nutritional problems were found in the perioperative period and 3 months after surgery.Through systematic literature search,the best evidence was extracted to construct a nutritional intervention regimen for elderly hip fractures patients with oral nutrition supplements(ONS).The expert meeting method was adopted to demonstrate the scheme and determine the final intervention scheme and process.Results A total of 7 guidelines were included,and 25 recommendations were formed based on evidence,including 24 strong recommendations and 1 weak recommendation.Nutritional intervention scheme and process for elderly patients with hip fractures,mainly ONS,were determined.The expert authority coefficient was 0.89.Conclusions In this study,the nutritional intervention regimen for elderly patients with hip fractures,mainly ONS,was constructed with a high degree of expert authority and reliable results,providing a theoretical basis for clinical nutrition intervention for elderly patients with hip fractures in the perioperative period.