晚期心力衰竭患者营养管理的最佳证据总结

Best evidence summary of nutrition management in patients with advanced heart failure

目的全面检索、分析和总结晚期心力衰竭患者营养管理的相关证据,为临床医护人员选择合适的营养管理策略提供参考。方法按照“6S”证据模型检索国内外数据库,获取与晚期心力衰竭患者营养管理相关的临床决策、推荐实践、指南、证据总结、系统评价、Meta分析和专家共识。检索时限为建库至2021年12月24日。采用证据总结评价工具、临床指南研究与评价系统II、澳大利亚乔安娜布里格斯研究所循证卫生保健中心对应的文献评价工具和证据分级系统进行文献质量评价和证据分级。结果共纳入13篇文献,汇总出31条最佳证据,分别包括营养筛查与评估、营养素推荐、营养支持、姑息治疗、健康教育5个类别。结论证据总结内容丰富、层次清晰,对开展晚期心力衰竭患者营养管理的临床实践有指导意义。护理人员在应用证据时,应基于具体临床情景,充分评估证据应用过程中的促进和阻碍因素,制订有针对性的行动计划,推进证据的落实。

Objective To comprehensively retrieve,analyze and summarize the evidence related to nutrition management of patients with advanced heart failure,so as to provide a reference for clinical doctors and nurses to select appropriate nutrition management strategies.Methods We searched domestic and foreign databases according to the"6S"evidence model to obtain clinical decisions,recommended practices,guidelines,evidence summary,system evaluation,meta-analysis and expert consensus related to nutrition management of patients with advanced heart failure.The retrieval time limit was from the establishment of the database to December 24,2021.Critical Appraisal for Summaries of Evidence,Appraisal of Guidelines for Research and EvaluationⅡ,literature evaluation tools and evidence grading system corresponding to the Joanna Briggs Institute Evidence-based Healthcare Center were used for literature quality evaluation and evidence grading.Results A total of 13 articles were included.A total of 31 pieces of best evidence were summarized,including five categories,namely nutrition screening and evaluation,nutrient recommendation,nutrition support,palliative treatment,and health education.Conclusions The summary of evidence is rich in content and clear in level,which is of guiding significance for the clinical practice of nutrition management of patients with advanced heart failure.When applying evidence,nurses should fully evaluate the factors that promote and hinder the application of evidence based on specific clinical situations,formulate targeted action plans,and promote the implementation of evidence.