CAJ | 학술논문

目的：探讨肠内营养不耐受的老年脑卒中患者的循证护理依据。方法依据 PICO原则和患者情况，提出个性化的临床问题，计算机检索 NGC、DARE、CDSR、CCRT、MEDLINE和CBM ，收集处理肠内营养不耐受（呕吐）护理措施的临床证据。结果最终共纳入2篇临床实践指南、1个meta分析和3个RCT。根据最终检索结果、患者病情和患者及家属意愿，采用匀速恒温定时输注营养制剂、控制血糖、使用胃动力药、更换营养制剂配方以及肠外营养辅助的综合护理治疗。结论针对病情复杂的老年脑卒中患者的营养支持采用循证医学的方法，可为患者提供既科学又个体化的护理。
목적：탐토장내영양불내수적노년뇌졸중환자적순증호리의거。방법의거 PICO원칙화환자정황，제출개성화적림상문제，계산궤검색 NGC、DARE、CDSR、CCRT、MEDLINE화CBM ，수집처리장내영양불내수（구토）호리조시적림상증거。결과최종공납입2편림상실천지남、1개meta분석화3개RCT。근거최종검색결과、환자병정화환자급가속의원，채용균속항온정시수주영양제제、공제혈당、사용위동력약、경환영양제제배방이급장외영양보조적종합호리치료。결론침대병정복잡적노년뇌졸중환자적영양지지채용순증의학적방법，가위환자제공기과학우개체화적호리。
Objective To provide evidence-based therapeutic schedule for an elder stroke patient vomiting when was undergoing enteral nutrition .Method The personalized clinical questions were put forward based on the PICO and patient’s condition ,and the following databases such as NGC ,The Cochrane Library of DARE ,CDSR ,CCTR , PubMed and CBM were searched to collect the best clinical evidences of improving the feeding tolerance for preven-ting vomit .Result Two clinical guidelines ,one systematic review and three randomized controlled trials were includ-ed finally .According to the retrieval outcomes ,patient’s clinical condition ,and patients and their family members’ willingness ,a reasonable nursing plan of EN was formulated :provide nutrition preparation regularly in a uniform speed with optimum temperature ,monitor gastric residual volume ,control blood sugar ,use Prokinetic drug ,change enteral nutition formula ,and apply parenteral nutrition for adjuvant treatment .By implementing these nursing meas-urements ,the patient developed a better gastrointestinal tolerance ,did not vomit any more ,and increased the nutri-tional intake .Conclusion Evidence-based approaches are helpful to provide a nursing plan that meets the needs of both scientific calness and individualization to elder stroke patient s who need nutrition support .