新生儿低体温预防和处理的最佳证据总结  

Summary of the best evidence for the prevention and treatment of neonatal hypothermia

作　　者：苏丽娜 杨雪兰 方晓纯 周立平[1] 邹文霞[1] SU Lina;YANG Xuelan;FANG Xiaochun;ZHOU Liping;ZOU Wenxia(Guangdong Provincial Hospital for Women and Children Health Care,Guangdong 510000 China)

机构地区：[1]广东省妇幼保健院,广东510000

出　　处：《循证护理》2024年第21期3820-3830,共11页Chinese Evidence-Based Nursing

摘　　要：目的:检索、评价并总结国内外关于新生儿低体温预防和处理的最佳证据,为临床实践提供参考,降低新生儿低体温的发生。方法:采用“PICO”方法确立问题,按“6S”证据模型系统检索相关文献,包括临床决策、系统评价、证据总结、临床实践指南等,检索时限为建库至2023年10月20日。由2名经过循证培训的研究人员独立进行文献质量评价与证据提取。结果:共纳入45篇文献,包括临床决策4篇、系统评价18篇、指南15篇、专家共识2篇、证据总结6篇,总结危险因素、分娩前准备、分娩时及分娩后处理、新生儿复苏、新生儿转运、新生儿复温、进入新生儿重症监护病房(NICU)或病房后的干预措施、体温监测、质量管理9个方面,共45条最佳证据,根据证据的可行性、适宜性、临床意义、有效性属性,确定39条A级、6条B级推荐证据。结论:总结的国内外新生儿低体温预防和管理最佳证据,可为临床医务人员提供循证依据。Objective:To retrieve,evaluate,and summarize the best evidence for the prevention and treatment of neonatal hypothermia in China and abroad,in order to provide a reference for clinical practice and reduce the incidence of neonatal hypothermia.Methods:The"PICO"strategy was used to establish the question,and the"6S"evidence model was used to systematically retrieve relevant literature,including clinical decision-making,systematic review,evidence summary,clinical practice guidelines,etc.The search time limit was from the establishment of the database to October 20,2023.Two researchers who had received evidence-based training independently conducted literature quality evaluation and evidence extraction.Results:A total of 45 articles were included,including 4 clinical decision-making articles,18 systematic reviews,15 guidelines,2 expert consensus articles,and 6 evidence summaries.A total of 45 pieces of best evidence were summarized from 9 aspects:risk factors,preparation before delivery,management during and after delivery,neonatal resuscitation,neonatal transfer,neonatal rewarming,intervention measures after entering the NICU or ward,temperature monitoring,and quality management.According to the feasibility,suitability,clinical significance,and effectiveness attributes of the evidence,39 A-level and 6 B-level recommended pieces of evidence were determined.Conclusions:The summarized best evidence for the prevention and management of neonatal hypothermia in China and abroad can provide an evidence-based basis for clinical medical staff.

关 键 词：新生儿 低体温 预防 循证护理 最佳证据 证据总结 

分 类 号：R473.72[医药卫生—护理学]