稳定期慢性阻塞性肺疾病患者营养管理的证据总结

Summary of the best evidence for nutrition management in patients with stable chronic obstructive pulmonary disease

目的全面检索和分析稳定期COPD患者营养管理的相关证据,并对最佳证据进行总结,为临床有效管理稳定期COPD患者的营养提供循证依据。方法计算机检索BMJ Best Practice、UpToDate、Scopus、Web of Science、中国生物医学文献数据库、知网、万方、维普、COPD全球倡议网站等中英文数据库、网站关于稳定期COPD营养管理的相关证据,包括临床实践指南、专家共识、证据总结、系统评价、Meta分析、随机对照试验,检索时限从2010年1月1日至2021年1月31日。由2名研究者对相关文献独立进行质量评价,并结合专业判断,对符合质量评价标准的文献进行证据的提取和汇总。结果共纳入14篇文献,包括7篇指南、2篇专家共识、3篇系统评价、1篇随机对照试验、1篇证据总结,最终从营养管理组织结构、营养风险筛查、营养评估、营养支持、饮食管理、体重监测6个方面形成25条COPD营养管理的最佳证据。结论该研究总结了稳定期COPD患者营养管理的最佳证据,临床医务人员应根据临床情境、患者意愿、证据应用的促进及阻碍因素选择最佳证据,以形成规范、有效、个体化的营养管理方案。

Objective To comprehensively search and analyze the relevant evidence of nutrition management in patients with stable chronic obstructive pulmonary disease(COPD).Methods We searched BMJ Best Practice,UpToDate,Scopus,Web of Science,SinoMed,CNKI,Wanfang,VIP,and Global Initiative For Chronic Obstructive Lung Disease from January 1,2010 to January 31,2021 to collect the literature including guidelines,expert consensuses,evidence summaries,systematic reviews,meta-analyses and randomized controlled trail(RCT).Two researchers independently evaluated the quality of the relevant literature,extracted and summarized the evidence.Results A total of 14 articles were included,including 7 guidelines,2 expert consensus,3 systematic reviews,1 RCT,and 1 evidence summary.Finally,25 pieces of best evidence were formed involving 6 aspects:organizational structure of nutrition management,nutrition risk screening,nutrition assessment,nutrition support,diet management,and weight monitoring.Conclusion This study summarized the best evidence of nutrition management for patients with stable COPD.Clinical medical staff should choose the best evidence according to the clinical situation,patients'wishes,the facilitors and barriers of evidence application,to form a standardized,effective and individualized nutrition management schedule.