目的 检索、评估并汇总国内外有关重症脑卒中患者肠内营养(enteral nutrition, EN)后高血糖管理的相关证据,为临床护理实践提供参考依据。方法 按循证检索资源的“6S”分类模型,计算机检索国内外数据库、指南网站和专业协会网站中与EN高血糖管理相关指南、专家共识、系统评价、证据总结和随机对照试验,检索时限为建库至2023年12月12日。由2名经过循证方法学系统培训的研究人员独立进行文献质量评价,并进行证据提取、整合和分级。结果 共纳入15篇文献,包括1篇随机对照试验,2篇系统评价,1篇证据总结,6篇指南,5篇专家共识,文献整体质量较高。从评估与筛查、血糖监测与控制目标、EN实施方案、高血糖管理、低血糖管理5个方面,总结出28条证据。结论 本研究梳理了重症脑卒中患者EN后高血糖管理及预防的最佳证据,可为临床EN相关血糖的管理提供循证依据。

Objective To search, evaluate and summarize the relevant evidence at home and abroad on the management of hyperglycemia after enteral nutrition (EN) in patients with severe stroke, so as to provide a reference basis for clinical nursing practice. Methods According to the “6S” classification model of evidence-based search resources, literatures related to the management of hyperglycemia after EN in patients with severe stroke were searched in domestic and foreign databases, guideline websites and professional association websites, including guidelines, expert consensus, systematic reviews, evidence summaries and randomized controlled trials. The search time limit was from the establishment of the database to December 12, 2023. Two researchers who have undergone systematic training in evidence-based methodology were independently responsible for literature quality evaluation, data extraction, summary and analysis. Results A total of 15 articles were included, involving 1 randomized controlled trial, 2 systematic reviews, 1 evidence summary, 6 guidelines, and 5 expert consensuses. The overall quality of the literatures was relatively high. From 5 aspects of assessment and screening, blood glucose monitoring and control targets, EN implementation plan, hyperglycemia management, and hypoglycemia management, 28 pieces of evidence were summarized.Conclusion This study summarized the best evidence for the management and prevention of hyperglycemia after EN in patients with severe stroke, which can provide an evidence-based basis for the management of blood glucose related to clinical EN and the standard of nursing quality.