重型颅脑损伤行亚低温疗法患者腹泻管理的最佳证据总结

Summary of the best evidence for diarrhea management in patients with severe craniocerebral injury treated with mild hypothermia therapy

目的检索并获取符合行亚低温疗法的重型颅脑损伤患者腹泻管理的最佳证据。方法按照循证资源6S模型自上而下的原则检索相关数据库和网站,对纳入文献进行质量评价、证据提取总结。结果纳入13篇有关文献,包括1篇临床决策、5篇指南、3篇专家共识、2篇随机对照试验、2篇系统评价。最终提取了腹泻病因评估筛查、相关指标监测与控制、合理进行肠内喂养、提高胃肠耐受性、腹泻并发症预防和人员培训与管理等6个维度,共26条证据。结论总结的行亚低温疗法的重型颅脑损伤患者腹泻管理相关证据,可为临床工作者对行亚低温疗法的重型颅脑损伤患者腹泻管理提供循证依据,进而降低患者腹泻发生率,改善住院期营养状态,早日实现身体康复。

Objective To retrieve and obtain the best evidence for diarrhea management in patients with severe craniocerebral injury who are treated with mild hypothermia therapy.Methods Relevant databases and websites were searched according to the top-down principle of the evidence-based 6S model,and the quality of the included articles was evaluated and evidence extracted and summarized.Results A total of 13 relevant literatures were included,including 1 clinical decisions,5 guidelines,3 expert consensus,2 RCTs and 2 systematic reviews.Finally,a total of 26 pieces of evidence were extracted from 6 dimensions,including etiology evaluation and screening of diarrhea,monitoring and control of related indicators,reasonable enteral feeding,improvement of gastrointestinal tolerance,prevention of diarrhea complications,and personnel training and management.Conclusion The relevant evidence of diarrhea management in patients with severe craniocerebral injury treated with mild hypothermia can provide evidence-based basis for clinical workers to manage diarrhea in patients with severe craniocerebral injury treated with mild hypothermia,so as to reduce the incidence of diarrhea in patients,improve the nutritional status during hospitalization,and achieve physical recovery as soon as possible.