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中国癌症防治杂志

中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (2): 207-.doi: 10.3969/j.issn.1674-5671.2025.02.12

• 论著 • 上一篇    下一篇

胃癌新辅助化疗患者术前营养干预的最佳证据总结

  

  1. 蚌埠医科大学；东部战区总医院全军普通外科研究所；南京大学医学院
  • 出版日期:2025-04-25 发布日期:2025-05-15
  • 通讯作者: 叶向红 E-mail：icuyz@126.com
  • 基金资助:
    军事医学创新工程项目（18CXZ040）；蚌埠医学院研究生科研创新计划项目（Byycx23021）

Best evidence of preoperative nutritional intervention in neoadjuvant chemotherapy for gastric cancer patients

  • Online:2025-04-25 Published:2025-05-15

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摘要： 目的 检索、汇总和评价关于胃癌新辅助化疗患者术前营养干预的证据，为临床实践提供循证依据。方法 按照证据资源“6S”模型，系统检索BMJ Best Practice、UpToDate、国际指南协作网、苏格兰校际指南网、欧洲临床营养与代谢协会、美国肠外肠内营养学会、中华医学会肠外肠内营养学分会、中国临床肿瘤学会等网站，以及PubMed、Web of Science、Ovid、Medline、Cochrane Library、JBI循证卫生保健中心数据库、中国生物医学文献数据库、中国知网、万方数据库等数据库中与胃癌新辅助化疗患者营养管理有关的中英文文献，文献类型包括临床决策、指南、专家共识、系统评价、Meta分析、证据总结、随机对照试验，检索时限为建库至2024年5月。由2名研究者独立完成文献筛选和质量评价，征询循证护理专家意见后，对符合质量标准的文献进行证据提取与汇总。结果 共纳入20篇文献，包括2篇临床决策、9篇指南、3篇专家共识、4篇系统评价、2篇随机对照试验，汇总了开展多学科团队合作、营养状况综合评估、营养干预措施、化疗常见消化道症状管理、营养教育及监测等5个主题共27条证据。结论 本研究从5个方面汇总了关于胃癌新辅助化疗患者术前营养干预的最佳证据共27条，具有较好的实用性和科学性。该发现为临床针对此类患者进行个体化营养干预提供循证依据。

关键词: 胃癌, 新辅助化疗, 营养干预, 循证护理, 最佳证据

Abstract: Objective To retrieve, synthesize and evaluate the evidence on preoperative nutritional intervention for gastric cancer patients undergoing neoadjuvant chemotherapy (NACT), and to provide an evidence⁃based foundation for clinical practice. Methods Following the "6S" evidence resource model, systematic searches were conducted in the databases or websites including BMJ Best Practice, UpToDate, the Guidelines International Network （GIN）, Scottish Intercollegiate Guidelines Network （SIGN）, European Society for Clinical Nutrition and Metabolism (ESPEN), American Society for Parenteral and Enteral Nutrition (ASPEN), Chinese Society of Parenteral and Enteral Nutrition (CSPEN), Chinese Society of Clinical Oncology (CSCO),   PubMed, Web of Science, Ovid, Medline, Cochrane Library, JBI Library,  China Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang Database for Chinese/English literature on nutritional management in gastric cancer NACT patients. Literature types included clinical decision⁃making, guidelines, expert consensuses, systematic reviews, Meta⁃analyses, evidence summaries, and randomized controlled trials with a search timeframe from database inception to May 2024. Two researchers independently performed literature screening and quality assessment. After consulting evidence⁃based nursing experts, evidence extraction and synthesis were conducted for qualified studies. Results A total of 20 articles were included: 2 clinical decisions, 9 guidelines, 3 expert consensuses, 4 systematic reviews, and 2 randomized controlled trials. Evidence was synthesized into 27 recommendations across 5 themes: multidisciplinary collaboration, comprehensive nutrition assessment, nutritional interventions strategies, chemotherapy gastrointestinal symptom management, nutrition education and monitoring. Conclusions This study synthesizes 27 pieces of best evidence on preoperative nutritional intervention for gastric cancer NACT patient across 5 domains, demonstrating strong practicability and scientific rigor. These findings provide actionable guidance for personalized nutritional management in clinical settings.

Key words:  Gastric cancer, Neoadjuvant chemotherapy, Nutritional intervention, Evidence?based nursing, Best evidence

中图分类号: 

  • R735.2