妊娠期高血压疾病防治循证意见专家咨询与分析  

Expert consultation and analysis of evidence-based opinion on prevention and treatment of hypertension during pregnancy

作　　者：李梅 李琼阁[2] 王金萍[3] 赵萌[3] 薛飞肖 胡斌[2] 薛小荣[2] 刘宇凡[2] Li Mei;Li Qiongge;Wang Jinping;Zhao Meng;Xue Feixiao;Hu Bin;Xue Xiaorong;Liu Yufan(Pharmacy Department,Xinghua People's Hospital,Xinghua 225700,China;Pharmacy Department,Xi’an No.4 Hospital,Xi'an 710004,China;Pharmacy Department,Xi'an Central Hospital,Xi'an 710004,China;Department of Clinical Laboratory,Xi'an No.3 Hospital,Xi'an 710018,China)

机构地区：[1]兴化市人民医院药剂科,225700 [2]西安市第四医院药剂科,710004 [3]西安市中心医院药剂科,710004 [4]西安市第三医院检验科,710018

出　　处：《国际医药卫生导报》2020年第10期1342-1346,共5页International Medicine and Health Guidance News

基　　金：陕西省重点研发计划项目(2017SF-252)。

摘　　要：目的对妊娠期高血压疾病防治循证意见进行专家咨询、分析。方法采用循证医学的方法,以“妊娠期高血压”“子痫”“先兆子痫”“hypertension pregnancyinduced”“eclampsia”“preclampsia”等为检索词,检索中国知网、万方医学网、Pubmed、Embase、The Cochrane Library、医脉通指南、世界卫生组织等数据库或网站,纳入指南、系统评价、meta分析、随机对照、病例对照、队列等临床研究,制定《妊娠期高血压疾病防治意见》进行专家咨询,并对结果进行分析、讨论。结果向26位专家咨询27条防治意见,集中趋势为1.75~5.00分,92.59%变异系数≤50%;17条意见基本达成共识,达成率62.96%,其中强推荐10条,弱推荐3条,不推荐4条,另有10条不确定其利弊情况;对重度妊娠期高血压建议立即使用硝苯地平短效(胶囊)、注射肼屈嗪、注射拉贝洛尔治疗(Q22、Q23,100.00%推荐),90%以上专家推荐硫酸镁、补钙防治子痫与先兆子痫,改善围产结局(Q7、Q11、Q12)。结论通过循证医学方法制定的《妊娠期高血压疾病防治意见》对于临床防治方案确定具有较大参考价值。Objective To carry out expert consultation and analysis of evidence-based opinions on prevention and treatment of hypertension during pregnancy.Methods By means of evidence-based medicine,we search"eclampsia","preclampsia",and"hypertension pregnancy-induced"from CNKI,Wanfang database,Pubmed,Embase,The Cochrane Library,The Guidelines for Medical Services,and The World Health Organization,etc.The guidelines,systematic evaluation/meta-analysis,randomized controlled studies,casecontrolled studies,cohort studies,and other studies were sorted out,and The Consultation Table of Opinions on Prevention and Treatment of Hypertension during Pregnancy was enacted for expert consultation.The consultation results were analyzed and discussed.Results The 27 opinions were consulted by 26 experts.The central tendency of the opinions was 1.75-5.00;and the variation coefficient of 92.59%opinions was≤50%.Consensus was basically reached on 17 opinions,with a reached rate of 62.96%;among which,10 were strongly recommended,3 were weakly recommended,4 were not recommended,and 10 were uncertain about their advantages and disadvantages.For the treatment of severe gestational hypertension,immediate use of nifedipine short-acting(capsule),injection of hydralazine or labetalol(Q22 and Q23,100.00%recommendation)were recommended.More than 90%of the experts recommended magnesium sulfate and calcium supplementation for the prevention and treatment of eclampsia and preeclampsia and for the improvement of perinatal outcome(Q7,Q11,and Q12).Conclusion The opinions on the prevention and treatment of pregnancy hypertension formulated by evidencebased medicine are of great reference value for the determination of clinical prevention and treatment program.

关 键 词：妊娠期高血压 循证医学 专家咨询 预防 治疗 

分 类 号：R714.246[医药卫生—妇产科学]