食管癌术后吻合口瘘患者肠内营养管理的最佳证据总结

doi:10.3760/cma.j.cn441417-20250625-21031

摘要/Abstract

摘要： 目的　检索与总结食管癌术后吻合口瘘患者肠内营养管理的最佳证据，为临床护理实践提供参考。方法　系统检索Up To Date、BMJ Best Practice、NICE、GIN、RNAO、SIGN、医脉通网站、CINAHL、PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方、维普关于食管癌术后吻合口瘘患者肠内营养管理的证据，纳入相关指南、系统评价等，检索时限为建库至2024年06月1日。由2名研究者独立评价文献质量并提取证据。结果　共纳入12篇文献，包括5篇指南，2篇专家共识、1篇Meta分析、4篇类实验研究。归纳出15条最佳证据，涵盖营养评估、摄入量、配方、体位、开始时间、输注速度和温度、胃肠不耐受预防、管道维护、动态监测与评价10个类别。结论　本研究总结的证据可为食管癌术后吻合口瘘患者的肠内营养提供循证证据，有助于改善食管癌术后吻合口瘘患者营养状况及预后。

关键词: 食管癌, 吻合口瘘, 肠内营养, 管理

Abstract:

Objective　To identify and synthesize the best available evidences on enteral nutrition management for patients with anastomotic leakage after esophageal cancer surgery, and to provide some references for clinical nursing practice. Methods　A systematic search was conducted across multiple databases and evidence sources, including Up To Date, BMJ Best Practice, NICE, GIN, RNAO, SIGN, YIMAITONG, CINAHL, PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, and VIP, for clinical guidelines, systematic reviews, and other studies related to enteral nutrition management in these patients. The search covered the records from the databases' establishment to June 1st, 2024. Two researchers independently evaluated the quality of the retrieved literature, and extracted relevant evidences. Results　Twelve articles were included: 5 guidelines, 2 expert consensus statements, 1 meta-analysis, and 4 quasi-experimental studies. Fifteen key pieces of best evidences were synthesized, and were categorized into 10 domains: nutritional assessment, nutrient intake, formula selection, patient positioning, initiation timing, infusion rate and temperature, prevention of gastrointestinal intolerance, tube care, and dynamic monitoring and evaluation. Conclusion　This study synthesizes evidence-based best practices for managing enteral nutrition in patients experiencing anastomotic leakage after esophageal cancer surgery, and these findings may improve patient nutritional status and clinical outcomes.

Key words: Esophageal cancer, Anastomotic leakage, Enteral nutrition, Management

於静孙仲文林飞云黄文婷. 食管癌术后吻合口瘘患者肠内营养管理的最佳证据总结[J]. 国际医药卫生导报, 2025, 31(21): 3676-3681.

Yu Jing, Sun Zhongwen, Lin Feiyun, Huang Wenting. Summary of best evidences for enteral nutrition management in patients with anastomotic leakage after esophageal neoplasms surgery[J]. International Medicine and Health Guidance News, 2025, 31(21): 3676-3681.

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