顺产产妇会阴损伤预防与修复循证指南的质量评价  

Quality appraisal of evidence-based guidelines on prevention and repair of perineal injury at vaginal delivery

作　　者：王晋芳[1] 徐杨[2] 陈延亭[2] 韩柳 姜雨婷 赵俊强[1] 李学靖[1] 马睛雅 郝玉芳[1] 

机构地区：[1]北京中医药大学护理学院,北京市100029 [2]中日友好医院妇产科 [3]北京大学第一医院护理部 [4]香港大学深圳医院护理部

出　　处：《中华护理杂志》2018年第2期162-168,共7页Chinese Journal of Nursing

摘　　要：目的评价国内外顺产产妇会阴损伤预防与修复的相关循证指南,分析各指南的特点,为临床进行基于证据的会阴损伤预防与修复的决策提供参考。方法系统检索专业学会网站、临床实践指南网站、数据库的会阴损伤预防与修复相关指南,采用临床研究与评估工具AGREEⅡ对符合纳入、排除标准的指南进行质量评价,并分析各指南的特点。结果共检索出国内外7部相关循证指南,在AGREEⅡ评价的6个领域平均标准化得分分别为范围和目的90.21%,参与人员68.25%,严谨性69.94%,清晰性89.41%,应用性70.63%和独立性68.25%。7部指南总体标准化得分均分为75.65%,总评分均分为5.67(满分7分),指南总体质量评价为4部A级,3部B级。结论会阴损伤预防与修复循证指南的总体质量较高,但部分指南在参与人员、严谨性、独立性领域仍有待完善。我国尚无满足循证指南标准的会阴损伤相关指南,国外高质量的循证指南经过本土化后可以作为我国临床开展会阴损伤预防与修复的循证证据。Objective To review the methodological quality of evidence-based guidelines on prevention and re- pair of perineal injury at vaginal delivery,and analyze the characteristics of guidelines to provide references for ev- idence-based decision-making. Methods We systematically searched websites of professional organizations,websites of clinical practice guidelines and databases for guidelines on prevention and repair of perineal injury ,and used A- GREE II to evaluate the chosen guidelines. Results We identified totally 7 relevant evidence-based guidelines in this field. The average standardized scores of guidelines in 6 domains of AGREE ]~ were 90.21%（scope and pur- pose）,68.25%（stakeholder involvement）,69.94%（rigor of development）,89.41%（clarity of presentations）,70.63%（ap- plieability）,and 68.25%（independence）,respectively. The overall standardized score for 7 guidelines was 75.65%, and the total score was 5.67 （7 points）. For overall quality,4 of them were grade A and 3 of them were grade B. Conclusion The overall quality of included guidelines were high,but stakeholder involvement,rigor of development and independence in some guidelines needs to be improved. There was no Chinese evidence-based gui-deline in this field,and high-quality foreign guidelines could be used as evidence in combination with local conditions.

关 键 词：会阴损伤 自然分娩 循证护理学 指南 临床研究与评估工具 

分 类 号：R473.71[医药卫生—护理学]