Abstract 【Objective】To search and screen the relevant evidence-based methods for preventing hypoglycemia in patients with gastrointestinal malignant tumor undergoing parenteral nutrition after operation. 【Methods】 The US National Guide Library,Scottish Intercollegiate Guide Network,Joanna Briggs Institute (JBI) website,Cochrane Library,PubMed,Web of Science,International diabetes Alliance website,VIP,CNKI,Wanfang database,Yimaitong and Chinese biomedical literature database were searched in order to explore the relevant methods to prevent hypoglycemia during parenteral nutrition treatment after operation of gastrointestinal malignant tumor. These data include guidelines,clinical decision-making,evidence summary,systematic evaluation and expert consensus.The retrieval period was from August 2021 to December 2021. Two researchers independently evaluated the quality of the literature,and extracted and summarized relevant evidence at the same time.【Results】 A total of 11 documents were included,including 2 guidelines,6 expert consensus,1 evidence summary,and 2 RCT papers. A total of 16 evidences were summarized,including 8 aspects,including preoperative evaluation,insulin addition method,recommended dose,blood glucose control,establishment of blood glucose management team,blood glucose monitoring program,parenteral nutrition solution configuration,and perioperative diet guidance.【Conclusion】It is comprehensive to summarize the best method to prevent hypoglycemia in patients with gastrointestinal malignant tumor after operation by parenteral nutrition,which can provide evidence basis for reducing the incidence of hypoglycemia in patients with gastrointestinal malignant tumor after operation by parenteral nutrition.
[1] BRAY F,FERLAY J,SOERJOMATARAM I,et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality world-wide for 36 cancers in 185 countries[J].CA Cancer J Clin,2018,68(6):394-424.
[2] 中国抗癌协会肿瘤营养与支持治疗专业委员会.胃癌患者营养治疗指南[J].全科医学临床与教育,2016,113(5):37-40.
[3] 中华医学会外科学分会结直肠外科学组.结直肠癌围手术期营养治疗中国专家共识(2019版)[J].中国实用外科杂志,2019,39(6):145-151.
[4] CHEN Y,LIU B L,SHANG B,et al.Nutrition support in surgical patients with colorectal cancer[J].World J Gastroenterol,2016,17 (13):1779-1786.
[5] DRISSI M,CWIELUCH O,LECHNER P,et al.Nutrition care in patients with cancer:A retrospective multicenter analysis of current practice-Indications for further studies?[J].Clin Nutr,2016,34(2):207-211.
[6] 程书蕙,陈波,李晔雄.原发性肝癌术后辅助治疗的研究进展[J].中华放射肿瘤学杂志,2019,28(3):233-237.
[7] 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,2015,20(11):964-967.
[8] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409.
[9] 陈凛,陈亚进,董海龙,等.加速康复外科中国专家共识及路径管理指南(2018版)[J].中国实用外科杂志,2018,38(1):1-20.
[10] 中华医学会《中华全科医师杂志》编辑委员会,《基层2型糖尿病胰岛素应用专家共识》编写专家组.基层2型糖尿病胰岛素应用专家共识[J].中华全科医师杂志,2021,20(7):726-736.
[11] 董明,周建平,姚宏伟.结直肠癌围手术期营养治疗中国专家共识(2019版)[J].中国实用外科杂志,2019,39(6):533-537.
[12] 陈莉明,陈伟,陈燕燕,等.成人围手术期血糖监测专家共识[J].中国糖尿病杂志,2021,29(2):81-85.
[13] 赵彬,老东辉,商永光.规范肠外营养液配制[J].协和医学杂志,2018,9(4):320-331.
[14] 中华医学会外科学分会胃肠外科学组,中华医学会外科学分会结直肠外科学组,中国医师协会外科医师分会上消化道外科医师委员会.胃肠外科病人围手术期全程营养管理中国专家共识(2021版)[J].中国实用外科杂志,2021,41(10):1111-1125.
[15] LOBO D N,GIANOTTI L,ADIAMAH A,et al. Perioperative nutrition:Recommendations from the ESPEN expert group[J].Clin Nutr,2020,39(11):3211-3227.
[16] 倪叶彬,陈亚梅,朱晓萍,等.糖尿病患者围手术期血糖管理的证据总结[J].中华护理杂志,2021,56(7):1079-1085.
[17] 李磊,刘鹏,李明,等.胰岛素在多腔袋肠外营养液中的稳定性研究[J].中华损伤与修复杂志(电子版),2020,15(3):231-234.
[18] 王子兵,王淑敏,宋桂花,等.创新肠外营养管理模式对胃癌手术患者的临床结局和成本效果的影响[J].中国慢性病预防与控制,2021,29(5):393-396.
[19] 张晓勇,吉龙舟.胃肠道恶性肿瘤术后早期肠内营养与肠外营养的临床对照探讨[J].中国医药指南,2018,16(11):8-9.
[20] SUDHAKARAN S. Guidelines for perioperative management of the diabetic patient[J].Surg Res Pract,2015,15(1):284063.
[1]
. [J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1729-1731.
2023, Vol. 40 
