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目的 整理肝硬化腹水患者肠内营养管理的最佳证据,为临床实践提供依据。方法检索UpToDate、BMJ Best Practice、Cochrane Library、PubMed、英国国家健康和保健医学研究所指南网、中国生物医学文献数据库、万方数据库中关于肝硬化腹水患者肠内营养管理的所有证据,包括系统评价、指南、证据总结、专家共识、临床决策、实践推荐。检索时限为建库至2020年6月。并采用Joanna Briggs Institute（JBI）循证卫生保健中心对应的质量评价工具对系统评价和专家共识进行质量评价和证据提取,利用2017年更新的AGREE Ⅱ对指南文献进行评价,从而确定提取证据的质量等级。 结果 共纳入8篇文献,其中系统评价1篇,指南6篇,专家共识1篇。从肝硬化腹水患者营养评定、各种营养摄入要求、肠内营养途径、肠内营养剂型、宣教与随访5个方面,共总结18条最佳证据。结论 肝硬化腹水患者肠内营养管理的证据总结来自于多个国家和地区,为今后医护工作者对肝硬化腹水患者进行肠内营养管理提供了循证依据。
Objective To summarize the best evidence of enteral nutrition management in patients with cirrhosis ascites. Methods Evidences of enteral nutrition management in patients with cirrhosis ascites were retrieved from the databases of UpToDate,BMJ Best Practice,Cochrane Library,PubMed,NICE,China Biomedical Literature Database,and Wanfang database from the inception to June 2020. The evidence resources could be systematic review,guideline,evidence summary,expert consensus,clinical decision making,and practice recommendation. The Joanna Briggs Institute（JBI） evidence-based health care center corresponding quality assessment tools for the system evaluation and expert consensus for quality assessment were both used for the quality assessment. The 2017 update of AGREE Ⅱ guide standards for guide literature evaluation was used to determine the quality level of evidence. Results A total of 8 papers were included with one systematic review,six guidelines and one expert consensus. A total of 18 best evidences were summarized from five aspects：nutritional assessment of patients with cirrhosis ascites,various nutritional intake requirements,enteral nutrition routes,enteral nutrition forms,and education and follow-up. Conclusion Evidence summary of enteral nutrition management for patients with cirrhosis ascites comes from multiple countries and regions in and out of China. The paper provides evidence-based basis for management of enteral nutrition in patients with cirrhosis ascites for medical workers in the future.