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作 者:贺钰 王紫莲[1] 张永美[1] 江雪纯 沈栩玲 徐美玲 韦群[1] HE Yu;WANG Zilian;ZHANG Yongmei;JIANG Xuechun;SHEN Xuling;XU Meiling;WEI Qun(Reproductive Medicine Center,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)
机构地区:[1]浙江大学医学院附属邵逸夫医院生殖医学中心,浙江杭州310016
出 处:《浙江大学学报(医学版)》2024年第5期632-640,共9页Journal of Zhejiang University(Medical Sciences)
基 金:浙江省中医药科技计划(2024ZF100);浙江省医药卫生科技计划(2024KY112)。
摘 要:目的:总结辅助生殖技术治疗患者卵巢过度刺激综合征管理的最佳证据,为医护人员管理卵巢过度刺激综合征提供循证依据。方法:系统检索UpToDate、BMJ Best Practice、世界卫生组织(WHO)网站、国际指南协作网(GIN)、英国国家医疗保健优化研究所(NICE)网站、美国国立指南网、美国生殖医学会(ASRM)网站、纽约科学院(NYAS)网站、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、Cochrane Library、CINAHL、PubMed、万方数据、中国知网和中国生物医学文献数据库中与辅助生殖技术治疗患者卵巢过度刺激综合征管理有关的证据,包括指南、临床决策、最佳临床实践、系统评价、专家共识、证据总结及相关原始研究。检索时限为建库至2024年5月31日。两名受过循证护理培训的研究人员独立进行文献质量评价,出现分歧时由第三名循证护理专家进行判断,最终决定纳入或剔除文献。结果:共纳入15篇文献,经质量评价后剔除1篇,剩余14篇包括5篇指南、3篇系统评价、2篇专家共识、1篇证据总结和UpToDate中的3篇。最终得到包括风险评估、病情监测、早期预防、制度管理、健康教育五个方面共27条最佳证据。结论:医护人员应早期开展卵巢过度刺激综合征的监测和预防,为患者提供个性化治疗方案,促使治疗资源得到合理配置,以提升对卵巢过度刺激综合征患者的有效管理。Objective:To summarize the best evidence for the management of ovarian hyperstimulation syndrome in patients undergoing assisted reproductive therapy.Methods:Evidence related to the management of ovarian hyperstimulation syndrome in patients undergoing assisted reproductive therapy,including guidelines,clinical decision,best clinical practice,systematic evaluation,expert consensus and evidence summary and related original research were systematically searched in UpToDate,BMJ Best Practice,World Health Organization(WHO)website,Guidelines International Network(GIN),National Institute for Health and Clinical Excellence(NICE)website,National Guidelines website,American Society for Reproductive Medicine(ASRM)website,New York Academy of Sciences(NYAS)website,Joanna Briggs Institute(JBI)database,Cochrane Library,CINAHL,PubMed,Wanfang database,CNKI,and China Biomedical Literature Database from inception to May 31,2024.Two researchers independently evaluated the quality of the literature,and a senior researcher made the final decision for literature inclusion.Results:A total of 15 articles were included in the study.Following quality assessment,one article was excluded.The remaining 14 articles included 5 practice guidelines,3 systematic reviews,2 expert consensuses,1 evidence summary,and 3 from UpToDate.Ultimately,27 pieces of evidence were identified across five key aspects:risk assessment,disease monitoring,early prevention,institutional management and health education.Conclusion:The updated evidence indicates that the monitoring and prevention of ovarian hyperstimulation syndrome should start early,personalized treatment plans should be provided for patients,and the rational allocation of treatment resources needs to be promoted to enhance effective management of ovarian hyper-stimulation syndrome.
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