目的 整合成年肝移植受者围手术期营养管理的最佳证据,为围手术期肝移植受者的临床照护提供参考。 方法 计 算机检索 JBI 循证护理数据库、专业指南网、临床决策支持系统、PubMed、Medline 及中国知识基础设施工程、万方数据知识服 务平台等,获取关于肝移植受者营养管理相关指南、证据总结、系统评价、专家共识等,检索时限为 2018 年 1 月 1 日至 2024 年 10 月 31 日。 由 2 名研究者对纳入的文献进行质量评价,并对证据进行提取、整合。 结果 本研究共纳入 3 篇指南、5 篇系统评 价、4 篇专家共识和 1 篇证据总结,按照最佳证据总结汇总步骤,共总结筛查与评估营养风险、营养治疗途径、肠内营养时机及 喂养速度、能量蛋白质及微量营养素管理、并发症营养管理以及出院营养管理 6 个方面 21 条证据。 结论 医护人员可以基于 总结的最佳证据,同时结合肝移植受者自身条件、临床情景、文化背景及价值观以及证据应用利益相关者主观意愿、促进及阻 碍因素等选择最佳证据,以形成科学、有循证依据的围手术期营养管理方案。

Objective To integrate the best evidence of perioperative nutrition management in liver transplant recipients and provide a reference for the clinical care of perioperative liver transplant recipients. Method Computer searched the JBI evidence-based care database international Guide Collaborative Network Clinical Decision Support System Cochrane Library PubMed Medline CNKI Wanfang database and so on to obtain relevant guidelines evidence summaries systematic review and expert consensus on the nutritional management of liver transplant recipients. The search period was from January 1 2018 to October 31 2024. Two investigators evaluated the quality of the literature extracted relevant evidence and integrated it. Result 13 articles were included 4 guidelines 5 systematic reviews 4 expert consensus and 1 evidence summary . 21 pieces of evidence were summarized from 6 aspects screening and assessment of nutritional risk nutrition and management pathways energy and protein intake initiation of enteral nutrition timing and feeding speed micronutrient supplementation Nutrition management for comorbidities and hospital discharge nutrition management. Conclusion The best evidence can be selected based on individual conditions cultural background and values and the subjective will promoting and hindering factors of stakeholders so as to form a scientific and evidence-based perioperative nutrition management plan.