中期医药科学2023年3月第13卷第5期·综述·卒中吞咽障碍患者营养风险管理证据总结明州彦1马秋平张杨2黄秀丹1曾汝汝·张纤1.广西中医药大学，广西南宁530200：2.广西中医药大学第一附属医院.广西南宁530200[摘要]目的为卒中吞咽障碍患者营养风险管理提供最佳证据。方法检索国内外数据库有关卒中吞咽障碍患者营养风险管理的证据，包括临床决策、指南、证据总结、系统评价、随机对照试验(RCT人专家共识。文献质量评价后根据主题对证据进行提取与汇总，检索时限为建库至2022年4月。结果纳入指南9篇、证据总结1篇、系统评价2篇、专家共识4篇，形成的最佳证据包括团队组建、吞咽障碍筛查与评估、营养风险筛查、营养评估、营养计划、肠内营养、肠外营养、营养监测、知识培训9个方面内容。结论本证据总结可为规范卒中吞咽障碍患者营养风险管理提供循证依据。[关键词]卒中；吞咽障碍；营养风险；证据总结[中图分类号]R743.3[文献标识码]A[文章编号]2095-0616(2023)05-0065-05Summary of evidence for nutrition risk management in strokepatients with dysphagiaMING Zhouyan'MA Qiuping ZHANG YangHUANG Xiudan'CAO Ruru'ZHANG Xian1.Guangxi University of Chinese Medicine,Guangxi,Nanning 530200,China;2.The First Affiliated Hospital ofGuangxi University of Chinese Medicine,Guangxi,Nanning 530200,China[Abstract]Objective To provide the best evidence for nutrition risk management in stroke patients with dysphagia.Methods The evidence for nutrition risk management in stroke patients with dysphagia was retrieved from domesticand foreign databases,including clinical decision-making,guidelines,summary of evidence,systematic evaluation,randomized controlled trial(RCT),and expert consensus.After the literature quality evaluation,the evidence wasextracted and summarized by topic,and the retrieval range spanned from the establishment of the database to April2022.Results There were 9 piece of guidelines,1 piece of summary of evidence,2 pieces of systematic evaluation,and 4 pieces of expert consensus included.The best evidence established included team building,screening andevaluation of dysphagia,nutrition risk screening,nutrition evaluation,nutrition plan,enteral nutrition,parenteralnutrition,nutrition monitoring,and knowledge training.Conclusion This summary of evidence may provideevidence basis for standardizing nutrition risk management in stroke patients with dysphagia.[Key words]Stroke:Dysphagia;Nutrition risk;Summary of evidence卒中吞咽障碍患者常因进食困难、营养摄人不1资料与方法足导致营养不良或营养风险增加。营养风险可导本研究在上海市循证护理中心网站注册，注册致患者感染性并发症发生率增加、住院时间延长等号：ES20220282。不良结局四。尽早对卒中吞咽障碍患者进行营养风1.1检索策略险筛查并根据筛查结果进一步干预已成共识，因此检索Up To Date、BMJ best practice、国际指南对卒中吞咽障碍患者进行营养风险管理具有重要协作网、美国国立指南库、英国国家临床优化研究意义。2019年中国卒中杂志发布了《中国卒中吞所、苏格兰学院间指南网、新西兰指南研究组、加拿咽障碍与营养管理手册》周，但其中营养风险管理内大安大略护理学会、医脉通、JBI、Cochrane Library、容较局限，缺乏实践指导。随着证据更新，本研究PubMed、Web of Science、Embase、Mediline、汇总卒中吞咽障碍患者营养风险管理证据，为卒中CINAHL、知网、万方等数据库。中文检索词为卒吞咽障碍患者营养风险管理提供循证依据。中/中风/脑血管意外/脑梗死/脑出血”“吞咽[基金项目]广西中医药大学高层次人才队伍建设三年行障碍/吞咽困难/咽下障碍”“营养风险/营养支动计划项目（桂中医大党〔2022]23号）。持/经口进食/营养不良”。英文检索词为“stroke/“通讯作者cerebrovascular accident/cerebral hemorrhage/CHINA MEDICINE AND PHARMACY Vol.13 No.5 March 202365(C)1994-2023 China Academic Journal Electronic Publishing House.All rights reserved.http://www.cnki.net
