主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2020, Vol. 20 ›› Issue (3): 328-334.doi: 10.3969/j.issn.1672-1756.2020.03.004

• 特别策划·临床营养管理 • 上一篇    下一篇

合并腹腔高压重症患者肠内营养期间误吸预防的证据总结

叶向红 张锐 王慧君 薛阳阳 李维勤   

  1. 东部战区总医院普通外科,210002 南京市(叶向红);重症医学科(薛阳阳,李维勤);南京大学医学院(张锐);蚌埠医学院(王慧君)
  • 出版日期:2020-03-15 发布日期:2020-03-15
  • 通讯作者: 李维勤,博士,主任医师,重症医学中心主任,全军普通外科研究所副所长,博士生导师,E-mail:liweiqindr@vip.163.com E-mail:E-mail:icuyz@126.com
  • 作者简介:叶向红,本科,主任护师,总护士长,硕士生导师,E-mail:icuyz@126.com
  • 基金资助:
    军事医学创新工程项目(18CXZ040)

Evidence analysis for aspiration prevention during enteral nutrition in critically ill patients with abdominal hypertension

YE Xianghong, ZHANG Rui, WANG Huijun, XUE Yangyang, LI Weiqin   

  1. General Hospital of Eastern Theater Command, Research Institute of General Surgery, Nanjing, 210002, China
  • Online:2020-03-15 Published:2020-03-15
  • Contact: E-mail:liweiqindr@vip.163.com E-mail:E-mail:icuyz@126.com

摘要: 目的:评价并整合合并腹腔高压的重症患者肠内营养期间预防误吸的证据。方法:检索BMJ Best Practice、Up To Date、国际指南协作网(GIN)、美国国立指南库(NGC)、Cochrane Library、PubMed、Web of Science、中国知网、万方、维普等数据库关于重症患者合并腹腔高压期间肠内营养误吸预防的所有证据,包括指南、证据总结、临床决策、专家共识、系统评价及原始研究。由两名研究者对纳入的文献进行质量评析,并对提取的证据级别进行评定。结果:共纳入文章17篇,其中系统评价8篇,指南3篇,最佳证据总结2篇,临床决策4篇。总结出20条误吸预防的证据,包括腹腔高压及误吸的危险因素的识别、肠内营养的管理、腹腔高压的管理、气道的管理、药物管理以及临床监测等。结论:建议在使用此证据时还应结合科室患者的具体情况进行个体化调整,并且此证据在临床使用过程中,若发现问题应及时改进,以提升护理质量,保证安全,提高患者满意度。

关键词: 重症患者;腹腔高压;肠内营养;误吸;循证护理

Abstract: Objective: To analyze the available evidences on aspiration prevention during enteral nutrition in critically ill patients with abdominal hypertension. Methods: We searched the data from Best practice (BMJ), Up To Date, Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), Cochrane Library, PubMed, Web of Science, CNKI, WanFang Database, VIP to collect literatures including guidelines, evidence summary, best practice recommendations reports, expert consensus report, systematic reviews and original guideline. Results: Totally 17 articles were selected, including 8 systematic reviews, 3 guidelines, 2 evidence summaries, 4 best practice recommendations reports. Finally 20 items of evidences were summarized with regard to identifying risk factors of abdominal hypertension and aspiration, enteral nutrition management, abdominal hypertension management, airway management, drug management and clinical monitoring. Conclusion: It is expected to provide useful information for nurses to prevent aspiration of patients in clinical practice, and improve patients safety and satisfaction.

Key words: critically ill patient; abdominal hypertension; enteral nutrition; aspiration; evidence-based nursing

中图分类号: 

  • R47