育龄期宫颈癌患者生育管理的最佳证据总结  

Summary of best evidence for fertility management in cervical cancer patients of childbearing age

作　　者：沈斐 从维莲 王春兰[3] 方群英[2] 闫鼎鼎[3] Shen Fei;Cong Weilian;Wang Chunlan;Fang Qunying;Yan Dingding(School of Nursing,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Breast Tumor Surgery,Zhejiang Cancer Hospital,Hangzhou 310022,China;Department of Gynecological Oncology Radiotherapy,Zhejiang Cancer Hospital,Hangzhou 310022,China)

机构地区：[1]浙江中医药大学护理学院,杭州310053 [2]浙江省肿瘤医院乳腺肿瘤外科,杭州310022 [3]浙江省肿瘤医院妇科肿瘤放疗科,杭州310022

出　　处：《中华现代护理杂志》2024年第4期446-452,共7页Chinese Journal of Modern Nursing

基　　金：浙江省医药卫生科技计划项目(2021KY570)。

摘　　要：目的检索、评价并总结育龄期宫颈癌患者生育管理的相关证据, 为临床医护人员对宫颈癌患者进行生育管理提供依据。方法系统检索UpToDate、Cochrane Library、BMJ Best Practice、中国指南网、中国知网、万方医学网、中国生物医学文献数据库、维普网等国内外循证医学数据库、临床决策系统、指南网站、相关专业协会网站、医学文献服务网站和数据库中与宫颈癌患者生育相关的证据, 包括临床决策、指南、证据总结、专家共识、系统评价。检索时限为建库至2023年3月1日。由2名系统学习过循证护理知识的研究者独立进行文献筛选和质量评价, 对符合要求的文献与临床专家共同讨论后完成证据提取、总结。结果共纳入11篇文献, 其中临床决策3篇, 指南4篇, 专家共识3篇, 系统评价1篇。总结的最佳证据包括生育评估与安全、生育力保存方法、生育保留手术方式及抗肿瘤治疗、生育时机、妊娠期管理与复查和妊娠合并宫颈癌的特殊处理6个方面共30条最佳证据。结论通过总结育龄期宫颈癌患者生育管理相关证据, 为临床医护人员对宫颈癌患者进行生育指导提供依据。临床应用时, 应充分考虑患者意愿、病情等因素, 提供个体化的治疗方案, 使患者利益最大化。Objective To retrieve,evaluate,and summarize the evidence on fertility management for cervical cancer patients of childbearing age,providing a basis for clinical medical and nursing staff to carry out fertility management for cervical cancer patients.Methods The evidence on fertility in cervical cancer patients included clinical decision-making,guidelines,summary of evidence,expert consensus,and systematic review,which were systematically searched on domestic and international evidence-based medicine databases,clinical decision-making systems,guideline websites,professional association websites,medical literature service websites,and databases such as UpToDate,Cochrane Library,British Medical Journal(BMJ)Best Practice,China Guidelines Network,China National Knowledge Infrastructure,WanFang Med Online,China Biology Medicine disc,and VIP.The search period was from database establishment to March 1,2023.Two researchers who received evidence-based nursing knowledge training independently conducted literature screening and quality evaluation,and jointly discussed with clinical experts on the literature that met the requirements to complete evidence extraction and summary.Results A total of 11 articles were included,including three clinical decision-making,four guidelines,three expert consensus,and one systematic review.A total of 30 pieces of best evidence were summarized from six aspects,including fertility assessment and safety,fertility preservation methods,fertility preservation surgery and anti-tumor treatment,fertility timing,pregnancy management and follow-up,and special treatment for pregnancy with cervical cancer.Conclusions The evidence on fertility management for cervical cancer patients of childbearing age provides a basis for clinical medical and nursing staff to provide fertility guidance for cervical cancer patients.In clinical application,factors such as patient willingness and condition should be fully considered,and personalized treatment plans should be provided to maximize patient benefits.

关 键 词：宫颈肿瘤 生育管理 证据总结 循证护理 

分 类 号：R473.73[医药卫生—护理学]