[1]孙 蜓,徐 瑶,李嘉琪,等.鼻饲病人鼻黏膜压力性损伤预防及护理的最佳证据总结[J].肠外与肠内营养杂志,2024,(06):370-375.[doi:10.16151/j.1007-810x.2024.06.009]
 SUN Ting,XU Yao,LI Jia-qi,et al.Summary of best evidence for prevention and care of nasal mucosal pressure injury in patients with nasal feeding[J].PARENTERAL & ENTERAL NUTRITION,2024,(06):370-375.[doi:10.16151/j.1007-810x.2024.06.009]
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鼻饲病人鼻黏膜压力性损伤预防及护理的最佳证据总结()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年06期
页码:
370-375
栏目:
论著
出版日期:
2024-12-10

文章信息/Info

Title:
Summary of best evidence for prevention and care of nasal mucosal pressure injury in patients with nasal feeding
作者:
孙 蜓 1徐 瑶1李嘉琪2左俊焘 2蔡丽娜 2郑恒宇2叶向红3
1.蚌埠医科大学研究生院,安徽蚌埠 233000;2.南京大学医学院,江苏南京 210093;3.东部战区总医院全军普通外科研究所,江苏南京 210002
Author(s):
SUN Ting1 XU Yao1 LI Jia-qi2 ZUO Jun-tao2 CAI Li-na2 ZHEN Heng-yu2 YE Xiang-hong3
1. Graduate School, Bengbu Medical University, Bengbu 233000, Anhui, China;2. Medical College of Nanjing University,Nanjing 210093,Jiangsu,China;3.Department of General Surgery,General Hospital of Eastern Theater Command,Nanjing 210002,Jiangsu,China
关键词:
肠内营养 鼻饲 鼻黏膜 黏膜压力性损伤
Keywords:
Enteral nutrition Nasal feeding Nasal mucosa Mucosal pressure injury
分类号:
R459.3
DOI:
10.16151/j.1007-810x.2024.06.009
文献标志码:
A
摘要:
目的:检索、评价和汇总国内外关于因鼻饲管引起的鼻黏膜压力性损伤的最佳证据,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UpToDate、国际指南协作网、JBI循证卫生保健中心图书馆、Web of Science、Cochrane Library、中国知网、万方等数据库及相关营养专业网站有关鼻黏膜压力性损伤的文献。检索时间为建库至2024年2月。文献筛选和质量评价由4名研究者独立完成,咨询循证专家意见后,对符合质量标准的文献进行证据提取、汇总。 结果:共纳入12篇文献,包括5篇指南、4篇专家共识、1篇临床决策、1篇系统评价、1篇证据总结,涵盖组建团队、鼻黏膜评估、鼻黏膜护理、鼻饲管的放置与维护、监测和教育5个主题24条证据。 结论:本研究总结的关于预防和护理因鼻饲管道引起的鼻黏膜压力性损伤的证据可应用于临床实践,促进鼻饲管道规范化管理,提高肠内营养实施效果。
Abstract:
Objective: To search, evaluate and summarize the best evidence about nasal mucosa pressure injury caused by nasal feeding tube at home and abroad, and provide evidence-based basis for clinical practice. Methods: According to the "6S" model of evidence resources, literatures related to nasal mucosal stress injury were systematically searched from UpToDate, Guidelines International Network, Joanna Briggs Institute Evidence-based Healthcare Center, Web of Science, Cochrane Library, CNKI, Wanfang database and other related nutrition professional websites. Thesearch period was from the establishment of the database to February 2024. Four researchers independently evaluated the literature quality, and after consulting the opinions of evidence-based experts, evidence was extracted and summarized for literatures that met the quality standards. Results: A total of 12 studies were included, including 5 guidelines, 4 expert consensus, 1 clinical decision, 1 systematic review and 1 evidence summary, covering 24 pieces of evidence on 5 topics, including team building, nasal mucosa evaluation, nasal mucosa care, placement and maintenance of nasal feeding tube, monitoring and education. Conclusions: The evidence of prevention and nursing of nasal mucosal pressure injury caused by nasal feeding tube can be applied to clinical practice, promote the standardized management of nasal feeding tube and improve the implementation effect of enteral nutrition.

参考文献/References:


[1] Fulbrook P, Lovegrove J, Butterworth J. Incidence and characteristics of hospital-acquired mucous membrane pressure injury: a five-year analysis[J]. J Clin Nurs, 2023, 32(13/14): 3810-3819.
[2] Motta APG, Rigobello MCG, Silveira RCDCP , et al. Nasogastric/nasoenteric tube-related adverse events: an integrative review[J].Rev Lat Am Enfermagem, 2021, 29: e3400.
[3] 晏 蓉, 李素云, 詹昱新, 等. 经鼻肠内营养并发鼻黏膜压力性损伤风险预警分级标准及干预方案的构建[J]. 中华临床营养杂志, 2020, 28(6): 346-350.
[4] Yal?in M, Güne? ?. A point prevalence study of medical deviceassociated pressure injuries: a cross-sectional study[J]. J Clin Nurs, 2023, 32(19/20): 7618-7625.
[5] 南锐伶 . ICU 患者鼻黏膜压力性损伤的影响因素研究[D]. 兰州: 兰州大学, 2021.
[6] 高 杰, 周会兰, 陈柯宇, 等. ICU病人鼻黏膜压力性损伤的研究进展[J]. 护理研究, 2023, 37(20): 3659-3664.
[7] 中国研究型医院学会老年外科专业委员会. 老年外科患者围手术期营养支持中国专家共识(2024版)[J]. 中华消化外科杂志,2024, 23(5): 629-641.
[8] Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009, 12(4): 99-101.
[9] 谢利民, 王文岳.《临床指南研究与评价系统Ⅱ》简介[J]. 中西医结合学报, 2012, 10(2): 160-165.
[10] 周英凤, 胡 雁, 朱 政, 等. JBI循证卫生保健中心文本证据的质量评价清单[J]. 护士进修杂志, 2024, 39(10): 1075-1080.
[11] 朱 政, 胡 雁, 周英凤, 等. 推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J]. 护士进修杂志, 2020, 35(11):996-1000.
[12] 王春青, 胡 雁 . JBI 证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11): 964-967.
[13] Richard AH, Liliana B. Inpatient placement and management of nasogastric and nasoenteric tubes inadults[EB/OL]. (2023-03-20)[2023-03-20]. https://www. uptodate. com/contents/inpatientplacement-and-management-of-nasogastric-and-nasoenterictubes-in-adults.
[14] European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel Pan Pacific Pressure Injury Alliance, in conjunction with Associate Organizations. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline[EB/OL] [2022-07-21]. https://internationalguideline.com/.
[15] Schroeder J, Sitzer V. Nursing care guidelines for reducing hospital-acquired nasogastric tube-related pressure injuries[J]. Crit Care Nurse, 2019, 39(6): 54-63.
[16] Bischoff SC, Austin P, Boeykens K, et al. ESPEN practical guideline: home enteral nutrition[J]. Clin Nutr, 2022, 41(2):468-488.
[17] Ministry of Health, Singapore. Nursing management of nasogastric tube feeding in adult patients[EB/OL]. [2023-03-08].https://www. hpp. moh. gov. sg/docs/librariesprovider4/guidelines/nasogastric-tube-feeding---book.pdf?sfvrsn=44466bf5_0.
[18] 邓子银, 刘加婷, 赵丽蓉, 等. 成人患者经鼻胃管喂养临床实践指南(2023年更新版)[J]. 护士进修杂志, 2024, 39(7): 673-679.
[19] Lyu Y, Huang YL, Li ZY, et al. Interventions and strategies to prevent medical device-related pressure injury in adult patients: a systematic review[J]. J Clin Nurs, 2023, 32(19/20): 6863-6878.
[20] Gefen A, Alves P, Ciprandi G, et al. Device-related pressure ulcers: SECURE prevention[J]. J Wound Care, 2020, 29(Sup2a):S1-S52.
[21] Doncaster and Bassetlaw Teaching Hospitals. Nasogastric tube management and care[EB/OL]. (2017-07-07) [2023-03-18]. https://www. dbth. nhs. uk/wp-content/uploads/2017/07/PAT-T-17-v-5-Nasogastric-Tube-Management-and-Care-Final.pdf.
[22] 中华护理学会 . 成人肠内营养支持的护理: T/CNAS 19-2020[S]. 北京: 中华护理学会, 2020.
[23] 中华护理学会 . 成人鼻肠管的留置与维护: T/CNAS 20-2021[S]. 北京: 中华护理学会, 2021.
[24] 张 锐, 叶向红, 王慧君, 等. 成人住院患者经鼻行管饲喂养中口鼻腔护理的最佳证据总结[J]. 中华现代护理杂志, 2022, 28(13): 1687-1692.
[25] 四川大学华西循证护理中心, 中华护理学会护理管理专业委员会, 中华医学会神经外科学分会. 中国卒中肠内营养护理指南[J]. 中国循证医学杂志, 2021, 21(6): 628-641.
[26] 胡少华, 付 红, 周月琴, 等. 多学科团队合作下老年共病患者的肠内营养管理[J]. 中国护理管理, 2020, 20(11): 1616-1620.
[27] Parvizi A, Haddadi S, Mollaei A, et al. A systematic review of nurses’ knowledge and related factors towards the prevention of medical device-related pressure ulcers[J]. Int Wound J, 2023, 20(7): 2843-2854.
[28] Saleh MYN, Ibrahim EIM. Prevalence, severity, and characteristics of medical device related pressure injuries in adult intensive care patients: a prospective observational study[J]. Int Wound J, 2023, 20(1): 109-119.
[29] Shapira-Galitz Y, Karp G, Cohen O, et al. Evaluation and predictors for nasogastric tube associated pressure ulcers in critically ill patients[J]. Isr Med Assoc J, 2018, 20(12): 731-736.
[30] Nan RL, Su YJ, Pei JH, et al. Characteristics and risk factors of nasal mucosal pressure injury in intensive care units[J]. J Clin Nurs, 2023, 32(1/2): 346-356.
[31] 陈 丽, 袁 慧, 李菊芳, 等. 肠内营养相关并发症预防与管理最佳证据总结[J]. 肠外与肠内营养, 2021, 28(2): 109-116.
[32] Graham A, Sutton D. Prevention of intraoperative pressure injuries caused by nasogastric tubes[J]. Br J Oral Maxillofac Surg, 2015, 53(6): 564-565.
[33] 刘天贶, 龙玉娟, 刘 欢, 等. ICU患者不同部位黏膜压力性损伤的特征及护理研究进展[J]. 护理学报, 2022, 29(8): 35-39.
[34] Wu XR, Qiu LZ, Cai M, et al. Prevention of hospital-acquired transnasal tube-related pressure injuries: a quality improvement project[J]. Wound Manag Prev, 2023, 69(3): 18-24.
[35] 甘 婷, 石 莹, 李 欢, 等. 国内不同材质胃管及其留置时间的研究进展[J]. 当代护士(中旬刊), 2017(12): 3-5.
[36] 吕 月, 丁 瑜, 罗 敏, 等. 聚氨酯鼻胃管在高龄长期管饲患者 中 的 留 置 时 间 研 究 [J]. 成 都 医 学 院 学 报 , 2022, 17(6):721-724.
[37] 刘春燕, 姚红林, 李嘉琪, 等. 家庭肠内营养个案管理的最佳证据总结[J]. 肠外与肠内营养, 2024, 31(5): 306-311.

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备注/Memo

备注/Memo:
作者简介 :孙 蜓,硕士研究生,主要从事临床营养护理相关研究。E-mail:suntt1217@163.com通讯作者 :叶向红,E-mail:icuyz@126.com
更新日期/Last Update: 1900-01-01