重症病人再喂养综合征研究的范围综述

Research on refeeding syndrome in severe patients:a scope review

目的:对重症病人再喂养综合征(RFS)的诊断标准、发生现状及RFS的影响因素进行范围综述,为RFS的预防及早期发现提供参考依据。方法:采用ARKSEY提出的范围综述的研究框架,检索PubMed、Web of Science、EMbase、the Cochrane Library、中国生物医学文献数据库、中国知网、维普数据库和万方数据库关于重症病人再喂养综合征的研究,检索时限为建库至2022年12月。由2名研究人员根据纳入与排除标准独立进行文献筛选、数据提取,收集并总结数据,报告研究结果。结果:共纳入16篇文献,未发现RFS统一的诊断标准,采用NICE提出的RFS诊断标准的研究居多;重症病人RFS的发生率为6.5%~73.5%,在不同研究和不同患病群体之间存在一定差异;重症病人RFS的主要影响因素包括人口学、营养、疾病、再喂养、生化指标及治疗。结论:应进一步探讨RFS的国际标准化定义、制定严格的筛查工具、标准化防治策略、开展个体化干预措施,为重症病人的RFS早期筛查及干预提供支持。

Objective:To review the diagnostic criteria,occurrence status and influencing factors of RFS in critically ill patients,so as to provide a reference for the prevention and early detection of RFS.Methods:Using the research framework of scope review proposed by ARKSEY,PubMed,Web of Science,EMbase,the Cochrane Library,CBM,CNKI,VIP and WanFang Database were searched for studies on the refeeding syndrome in critically ill patients.The retrieval time was from the inception to December 2022.According to the inclusion and exclusion criteria,two researchers independently screened the literature,extracted the data,collected and summarized the data,and reported the study results.Results:A total of 16 articles were included,and no unified RFS diagnostic criteria were found.The majority of studies used the RFS diagnostic criteria proposed by NICE.The incidence of RFS in critically ill patients ranged from 6.5%to 73.5%,and there were some differences among different studies and different disease groups.The main influencing factors of RFS in critically ill patients included demography,nutrition,disease,refeeding,biochemical indicators and treatment.Conclusion:It is necessary to further explore the international standardized definition of RFS,formulate strict screening tools,standardize prevention and treatment strategies,and carry out individualized intervention measures to provide support for early screening and intervention of RFS in critically ill patients.