听神经瘤患者围手术期营养管理的最佳证据总结

Best evidence summary of nutrition management in patients of acoustic neuroma during the perioperative period

目的总结、评价关于听神经瘤患者围手术期营养管理的最佳证据,为临床护理人员提供循证依据。方法检索BMJ最佳临床实践、UpToDate、Cochrane Library、国际指南网、苏格兰学院间指南网、加拿大安大略注册护士协会官网、JBI澳大利亚循证卫生保健中心、PubMed、Embase、CINAHL、医脉通、中国生物医学文献数据库、中国知网、万方数据库等国内外数据库有关围手术期营养管理相关临床实践指南、专家共识、证据总结、系统评价、随机对照试验等,检索时间限制为2013年6月1日至2023年6月1日,对纳入的文章进行质量评价,并进行证据提取、等级评定及汇总分析。结果共纳入17篇文献,包括5篇指南、6篇专家共识、2篇证据总结、2篇系统评价及2篇随机对照试验,共形成27条最佳证据,涵盖营养管理团队建设、营养及吞咽障碍的筛查与评估、营养支持时机与实施途径、营养管理具体措施、出院后延续营养管理5个方面内容。结论本研究总结了有关听神经瘤围手术期营养管理的最佳证据,为临床护理人员提供了循证依据。但其推荐意见尚缺乏专科性、部分意见存在争议、且来自多个国家,在临床实践时应结合临床实际情况及其他相关因素综合分析,有所取舍,以促进临床护理质量的提升。

Objective To summarize and evaluate the best evidence of perioperative nutrition management for patients with acoustic neuroma,and to provide evidence-based basis for clinical nurses.Methods BMJ best clinical practice,UpToDate,Cochrane Library,Guidelines International Network,Scottish Intercollegiate Guidelines Network,the official website of Ontario Registered Nurses Association,JBI Australian evidence-based health care center,PubMed,Embase,CINAHL,Yimaitong,Chinese biomedical literature database,CNKI,Wanfang database and other domestic and foreign databases related to clinical practice guidelines,expert consensus,evidence summary,systematic evaluation,sysmtem analysis,clinical randomized scientific control were seached.The retrieval time was limited from June 1st,2013 to June 1st,2023.Evaluated the quality of the included literatures,and conduct evidence extraction,grade evaluation and summary analysis.Results A total of 17 literatures were included,including 5 guidelines,6 expert consensus,2 best practices and evidence summary,2 system evaluation and 2 randomized scientific control.A total 27 of best evidence was formed,covering five aspects:nutrition management team construction,screening and evaluation of nutrition and dysphagia,timing and implementation of nutrition support,specific measures of nutrition management,continuous nutrition management after discharge.Conclusions This study summarized the best evidence of perioperative nutritional management of acoustic neuroma,and provides evidence-based basis for clinical nurses.However,its recommendations are not specialized,some of them are controversial,and come from many countries.In clinical practice,we should make a comprehensive analysis in combination with the actual clinical situation and other relevant factors,and make some choices,so as to promote the improvement of clinical nursing quality.