胃肠道疾病患儿围术期营养支持治疗的最佳证据总结

Summary of the best evidence of nutritional support therapy in children with gastrointestinal diseases during perioperative period

目的:评价并总结胃肠道疾病患儿围术期营养支持治疗的最佳证据,为规范胃肠道疾病患儿围术期的营养管理提供参考依据。方法:计算机检索BMJ Best Practice.Up To Date.加拿大安大略注册护士协会(RNAO)官网、英国国家卫生与临床技术优化研究所(NICE)官网、国际指南网(GIN)、苏格兰学院间指南网(SIGN)、美国医疗保健研究与质量局(AHRQ)网站、JoannaBriggs Institute(JBI)循证卫生保健中心数据库、Cochrane Library、欧洲临床营养与代谢协会(ESPEN)官网、美国肠外肠内营养学会(ASPEN)官网、PubMed、中国生物医药文献数据库、万方、中国知网中关于胃肠道疾病患儿围术期营养支持治疗的相关文献。采用JBI证据预分级及证据推荐级别系统(2014)对证据进行级别和推荐强度的划分。结果:共纳入16篇文献,包括2篇最佳实践、3篇证据总结、5篇指南、3篇系统评价、3篇专家共识。汇总出胃肠道疾病患儿围术期营养支持治疗的最佳证据32条,涉及营养支持流程、营养团队建设、营养筛查、营养评估和监测、营养干预、营养干预途径选择6个方面。结论:胃肠道疾病患儿围术期营养支持治疗应通过多学科协作,根据营养筛查结果,进行营养干预。

Objective:To evaluate and summarize the best evidence of nutritional support therapy for children with gastrointestinal diseases during perioperative period,and to provide reference for standardizing the nutritional management of children with gastrointestinal diseases during perioperative period.Methods:Literatures related to nutritional support therapy in children with gastrointestinal diseases during perioperative period from databases,such as BMJ Best Practice,Up to Date,RNAO,NICE,GIN,SIGN,AHRQ,JBI,Cochrane Library,ESPEN,ASPEN,PubMed,CBM,Wanfang Data and CNKI,were retrieved by computers.JBI Evidence Pre-grading and Evidence Recommendation Level System(2014)was used to classify the level of evidence and the strength of recommendation.Results:A total of 16 articles were included,involving 2 best practice recommendation statements,3 evidence summaries,5 guidelines,3 systematic reviews,and 3 expert consensuses.There were 32 best evidences of nutritional support therapy in children with gastrointestinal diseases during perioperative period,which were summarized,involving nutrition support process,nutrition support team construction,nutrition screening,nutrition assessment and monitoring,nutrition intervention and nutrition intervention approaches.Conclusion:The nutritional support therapy of children with gastrointestinal diseases during perioperative period should be conducted by multidisciplinary collaboration.Nutrition intervention should be carried out according to the results of nutrition screening.