成人中重度烧伤患者营养管理的最佳证据总结

Evidence summary of nutritional management in adults with moderate and severe burns

目的检索并总结成人中重度烧伤患者营养管理的最佳证据。方法系统检索国内外数据库和相关协会官方网站,检索时限为建库至2022年12月31日,对文献进行质量评价、提取证据。结果共纳入24篇文献,包含指南8篇、临床决策4篇、系统评价6篇、证据总结5篇、专家共识1篇。总结了早期识别营养不良风险与整体评估,组建跨学科营养管理团队,营养干预对象和时机,营养干预途径的选择和注意事项,制订个体化的营养管理计划,能量需求监测,动态观察、随时评价,出院指导及健康教育8个类别共31条证据。结论医护人员在证据应用过程中应结合患者实际情况,有针对性地选择最佳证据,降低烧伤患者的营养不良发生率,提高护理质量。

Objective To search and summarize the best evidence of nutrition management in adult patients with moderate and severe burns.Methods Domestic and foreign databases and official websites of relevant associations were systematically searched until December 31,2022,and the quality of literature was evaluated and evidence was extracted.Results A total of 24 literature were included,including 8 guidelines,4 clinical decisions,6 systematic reviews,5 evidence summaries,and an expert consensus.A total of 31 pieces of evidence were summarized into 8 categories,including early risk identification and overall assessment of nutrition,establishment of interdisciplinary nutrition management team,nutrition intervention objects and timing,selection of nutrition intervention approaches and matters needing attention,formulation of individualized nutrition management plan,energy demand monitoring,dynamic monitoring,on-the-go evaluation,discharge guidance and health education.Conclusion Medical staff should select the best evidence according to the actual situation of patients in the process of evidence application,reduce the incidence of malnutrition in burn patients and improve the quality of nursing.