宫颈环扎术后孕妇妊娠期管理最佳证据总结  

Summary of the best evidence for the management of pregnant women during pregnancy after cervical cerclage

作　　者：赵美慧 庄惠人[3] 陈秋霞 冯芳茗[2] 王文静[4] 杨芳芳 Zhao Meihui;Zhuang Huiren;Chen Qiuxia;Feng Fangming;Wang Wenjing;Yang Fangfang(Tongji University School of Medicine,Shanghai 200092,China;Department of VIP,East Hospital Affiliated to Tongji University,Shanghai 200120,China;Department of Nursing,East Hospital Affiliated to Tongji University,Shanghai 200120,China;Department of Obstetrics and Gynecology,East Hospital Affiliated to Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学医学院,上海200092 [2]同济大学附属东方医院特诊部,上海200120 [3]同济大学附属东方医院护理部,上海200120 [4]同济大学附属东方医院妇产科,上海200120

出　　处：《中国实用护理杂志》2024年第17期1310-1318,共9页Chinese Journal of Practical Nursing

基　　金：上海市浦东新区卫生委员会重要薄弱学科建设项目(PWZbr2022-04)。

摘　　要：目的检索、筛选、评价和整合宫颈环扎术后孕妇妊娠期管理相关证据,为临床实践提供依据。方法根据"6S"证据资源金字塔模型,系统检索UpToDate、BMJ最佳临床实践、国际指南协作网、美国指南网、世界卫生组织网站、医脉通、梅斯医学网站、临床指南网站、美国妇产科医师学会、英国皇家妇产科学院、加拿大妇产科医师学会、法国妇产科学院、欧洲围产医学协会、Cochrane Library、澳大利亚乔安娜布里格斯研究所(JBI)、循证卫生保健中心数据库、PubMed、Embase、Scopus、Web of Science、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于宫颈环扎术后孕妇妊娠期管理的所有证据,包括临床决策最佳实践、指南、专家共识、证据总结、系统评价、Meta分析。检索时限为建库至2023年3月1日,由2名研究者独立进行文献质量评价后,根据主题对证据进行提取与汇总。结果共筛选出8篇文献,包括2篇专家共识、2篇系统评价和4篇指南。通过文献阅读、证据提取和归类,从系统化管理、活动管理、用药管理、健康行为管理、妊娠期监督、环扎线拆除时机监督和心理状态监督7个方面总结出23条最佳证据。结论本研究总结的宫颈环扎术后孕妇妊娠期管理最佳证据质量高、权威性强,可为临床医护人员提供循证依据,建议加强宫颈环扎术后孕妇妊娠期间的管理,动态、持续评估孕妇妊娠情况,审慎地选用证据完善产检流程,保证母婴安全,减少并发症的发生。总的来说,有效的宫颈环扎术后孕妇妊娠期管理需要综合考虑许多因素,从而确保母婴的健康和安全。Objective To retrieve,screen,evaluate and synthesize evidence related to the management of pregnant women during pregnancy after cervical cerclage to provide a basis for clinical practice.Methods According to the"6S"evidence resource pyramid model,the system searched of all evidence on the management of pregnant women after cervical cerclage in databases suchas UpTo Date,BMJ Best Clinical Practice,International Guidelines Network,American Guidelines Network,World Health Organization website,Yimaitong,Metz Medical website,Clinical Guidelines website,American College of Obstetricians and Gynaecologists,Royal College of Obstetricians and Gynaecologists of the United Kingdom,Canadian College of Obstetricians and Gynaecologists,French College of Obstetricians and Gynaecologists,European Association of Perinatal Medicine,Cochrane Library,the Joanna Briggs Institute(JBI),the Centre for Evidence-Based Health Care Database,PubMed,Embase,Scopus,Web of Science,CNKI,Wanfang Database,VIP Database,and China Biomedical Literature Database,including best dicision practices,guidelines,expert consensus,evidence summary,systematic reviews,Meta-analysis.The search time limit was the establishment of the database to March 1,2023,and the evidence was extracted and summarized according to the theme after the two researchers independently evaluate the quality of the literature.Results A total of 8 studies were selected,including 2 expert consensuses,2 systematic reviews and 4 guidelines.Through literature reading,evidence extraction and classification,23 pieces of best evidence were summarized from seven aspects:systematic management,activity management,medication management,health behavior management,pregnancy supervision,supervision of the timing of cerclage removal and supervision of psychological state.Conclusions The best evidence quality and autuority of pregnancy management for pregnamt women after cervical cerclage surgery summarized in the study are high.It was recommended to strengthen the management of pregnant women during p

关 键 词：宫颈功能不全 宫颈环扎术 证据总结 循证护理学 

分 类 号：R473.71[医药卫生—护理学]