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中国癌症防治杂志

中国癌症防治杂志 ›› 2024, Vol. 16 ›› Issue (3): 339-345.doi: 10.3969/j.issn.1674-5671.2024.03.12

• 临床研究 • 上一篇    下一篇

加速康复理念下结直肠癌患者围手术期营养管理的最佳证据总结

  

  1. 南京大学医学院；中国人民解放军东部战区总医院普通外科；蚌埠医学院研究生院
  • 出版日期:2024-06-25 发布日期:2024-06-25
  • 通讯作者: 叶向红， E?mail：icuyz@126.com

Summary of the best evidence for perioperative nutritional management in patients with colorectal cancer by the concept of enhanced recovery 

  • Online:2024-06-25 Published:2024-06-25
  • Supported by:
    军事医学创新工程项目（18CXZ040）

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摘要： 目的 检索、筛选、评价并整合加速康复理念下结直肠癌患者围手术期营养管理的最佳证据。方法 按照循证资源“6S”模型自上向下检索BMJ最佳临床实践、Up to Date、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、国际指南协作网、英国国家卫生与临床优化研究所网站、PubMed、Cochrane系统评估数据库、Medline、中国生物医学文献数据库、中国知网、万方数据库、医脉通、美国加速康复协会、中华医学会、美国肠外肠内营养学会、欧洲临床营养与代谢学会等关于加速康复理念下结直肠癌患者围手术期营养管理的中文和英文相关文献，文献类型包括临床决策、指南、专家共识、系统评价（Meta分析）等，检索时限为建库至2023年11月。由两位研究人员独立对纳入文献进行质量评价，对符合质量标准的文献进行证据内容的提取与总结。结果 最终纳入15篇文献，其中专家共识7篇，指南5篇，系统评价3篇，汇总了涉及营养治疗原则、术前宣教、术前营养筛查与评估、术前营养支持、术前禁食禁饮、术后营养支持、出院后营养支持等7个类别的24条最佳证据。结论 本研究从7个方面总结了加速康复外科理念下结直肠癌患者围手术期营养管理最佳证据24条，具有较好的实用性和科学性，可为医护人员实施营养管理提供循证依据。

关键词: 结直肠癌, 围手术期, 营养管理, 加速康复, 最佳证据

Abstract: Objective To search, screen, evaluate and integrate the best evidence of perioperative nutritional management for patients with colorectal cancer by the concept of accelerated rehabilitation. Methods According to the "6S" model of evidence⁃based resources, we retrieved from top down the literature, in both Chinese and English, on the perioperative nutritional management of colorectal cancer patients by the concept of accelerated rehabilitation, in BMJ Best Practice, Up to Date, Joanna Briggs Institute for Evidence⁃Based Health Care Database, International Guidelines Collaboration, Website of National Institute for Health and Clinical Excellence, PubMed, Cochrane Library, Medline, CBMdisc, CNKI, Wanfang Database, Medlive, American Society for Enhanced Recovery, Chinese Medical Association, American Society for Parenteral Enteral Nutrition, and European Society for Clinical Nutrition and Metabolism. The extent of literature covered clinical decision⁃making, guidelines, expert consensus, and systematic evaluation (Meta⁃analysis). The search time limit was from the establishment of the database to November 2023. The quality of the included literature was independently evaluated by two researchers, and the references that met the quality criteria were analyzed. Results A total of 15 references including 7 expert consensus, 5 guidelines and 3 systematic evaluation were retrieved, summarizing 24 pieces of best evidence, which were grouped into 7 categories of nutritional treatment principles, preoperative education, preoperative nutritional screening and evaluation, preoperative nutritional support, preoperative fasting and drinking restriction, postoperative nutritional support and post⁃discharge nutritional support. Conclusions 24 pieces of the best evidence are summarized, from 7 aspects, on the perioperative nutrition management of colorectal cancer patients under the concept of accelerated rehabilitation surgery, which has good practicality and scientificity, and providing an evidence⁃based basis for medical staff to implement nutrition management.

Key words: Colorectal cancer；Perioperative；Nutrition management；Enhanced recovery；Summary of the best evidence 

中图分类号: 

  • R735.3+5