促进足月孕产妇泌乳启动与建立的最佳证据总结  

Summary of the best evidence on initiation and establishment for promoting the full-term maternal lactation

作　　者：李苏杭 朱丽群[1] 金华怡[1] 庄若[1] 厉丽 夏青[1] 刘兰平[1] 仲蕾媛 包磊 马小艳[1] LI Suhang;ZHU Liqun;JIN Huayi;ZHUANG Ruo;LI Li;XIA Qing;LIU Lanping;ZHONG Leiyuan;BAO Lei;MA Xiaoyan(Affiliated Hospital of Jiangsu University,Zhenjiang 212000,Jiangsu,China;Jiangsu University,Zhenjiang 212013,Jiangsu,China)

机构地区：[1]江苏大学附属医院,江苏镇江212000 [2]江苏大学,江苏镇江212013

出　　处：《护士进修杂志》2024年第24期2614-2620,共7页Journal of Nurses Training

基　　金：国家卫生健康委医院管理研究所医疗质量循证管理持续改进研究项目(编号:YLZLXZ22G033);镇江市科技创新资金项目(编号:RK2019029)。

摘　　要：目的检索、评价并整合国内外促进足月孕产妇泌乳启动与建立的最佳证据。方法采用PIPOST模式构建循证问题,按照“6S”证据模型自上而下检索BMJ、Up To Date、JBI图书馆、加拿大安大略注册护士协会网站、英国国家临床医学研究所指南库、苏格兰学院间指南网、加拿大医学会临床实践指南、医脉通、Cochrane Library、PubMed、CINAHL、中国生物医学文献数据库、中国知网等数据库及相关专业协会网站中涉及促进足月孕产妇泌乳启动与建立的所有证据,并对纳入文献进行质量评价、证据提取与汇总。检索时限为建库至2023年4月1日。结果共纳入18篇文献,包括3篇专题证据汇总、4篇指南、5篇证据总结及6篇系统评价,并整合出组织管理、前馈风险管控、泌乳启动和泌乳建立4个维度27个条目的证据。结论本研究整合了促进足月孕产妇泌乳启动与建立的最佳证据,为科学决策提供了依据。医疗机构应基于证据制定政策引导、支持母乳喂养;母乳喂养专业人员应综合考虑组织机构资源、地域文化差异、孕产妇具体情况及意愿灵活应用最佳证据,切实把握关键窗口期,优化孕产妇泌乳启动与建立管理策略,支持和指导产妇和婴儿成功建立母乳喂养,从而提升纯母乳喂养率及母乳喂养持续时间。Objective To select,extract,and integrate the best evidence to promote the initiation and establishment of full-term maternal lactation at home and abroad.Methods The PIPOST model was used to construct evidence-based questions,and according to the"6S"evidence model,all evidence concerning the promotion of full-term maternal lactation initiation and establishment in BMJ,Up To Date,The Joanna Briggs Institute(JBI)Library,The Registered Nurses Association of Ontario(RNAO),The National Institute for Health and Care Excellence(NICE),The Scottish Intercollegiate Guidelines Network(SIGN),The Canadian Medical Association(CMA),Yimaitong,Cochrane Library,PubMed,CINAHL,China Biology Medicine disc(CBMdisc),CNKI,and the websites of related professional associations were searched from top to bottom.The quality of the included literature was evaluated,evidence was extracted and summarized.The search time was from the establishment of the database to April 1,2023.Results A total of 18 articles were included,including 3 thematic evidence summary,4 guidelines,5 evidence summaries,and 6 systematic reviews.The evidence of 27 items in 4 dimensions,covering organizational management,feed forward risk control,lactation initiation and lactation establishment were integrated.Conclusion This study integrates the best evidence to promote the initiation and establishment of full-term maternal lactation,so as to provide a basis for scientific decision-making.Medical institutions should develop policies to guide and support breastfeeding based on evidence;Breastfeeding professionals should take into account organizational resources,regional cultural differences,and the specific conditions and willingness of pregnant women to flexibly apply the best evidence,and grasp the key window period,and optimize the term maternal lactation start and establish management strategy,and support and guide maternal and infant successfully establish breastfeeding,so as to improve the rate of exclusive breastfeeding and the duration of breastfeeding.

关 键 词：泌乳 母乳喂养 证据总结 循证护理 

分 类 号：R473.71[医药卫生—护理学]