系统性红斑狼疮患者生育期保健的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.04.012

摘要/Abstract

摘要：

目的检索、筛选、总结并分析系统性红斑狼疮（systemic lupus erythematosus，SLE）患者生育期保健的相关证据并形成最佳证据总结，为SLE患者生育期的护理及管理提供循证依据。方法系统检索美国指南网、英国国家卫生和临床优化研究所网站、UpToDate、PubMed、Web of Science、Cochrane Library、BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、医脉通、中国生物医学文献数据库、中国知网和万方数据库中与SLE患者生育期保健有关的所有证据，包括指南、专家共识、证据总结、临床决策和Meta分析。检索时限为2011年1月1日—2021年11月18日。由2名研究者对纳入的文献进行质量评价和资料提取，并对符合要求的文献进行证据总结和归纳。结果共纳入10篇文献，包括临床决策1篇、指南4篇、专家共识3篇和Meta分析2篇。最终形成包括计划妊娠、孕期监测及随访、孕期用药管理、哺乳及新生儿管理4个方面，共21条的最佳证据。结论护理人员应结合临床特点和工作环境，考虑SLE患者个体情况后对其进行持续、动态的评估，制订治疗和护理方案，改善母婴结局，提高患者生活质量。

关键词: 系统性红斑狼疮, 生育期, 管理, 证据总结, 循证护理学

Abstract:

Objective The relevant evidence of perinatal management of systemic lupus erythematosus（SLE） patients was searched，screened，summarized and analyzed，and the best evidence summary was formed，so as to provide a reliable evidence-based basis for the clinical management and nursing care of SLE patients in the perinatal period. Methods A systematic search was conducted on US Guide Network（National Guideline Clearinghouse，NGC），UK National Institute of Health and Clinical Technology Optimization（National Institute for Health and Clinical Excellence，NICE），UpToDate，PubMed，Web of Science，Cochrane Library，BMJ Best Practice，Australia Joana Briggs Institute（JBI） Evidence-based Health Care Center Database，Yimaitong，China Biomedical Literature Database，China National Knowledge Infrastructure and Wanfang Database for all the evidence related to the perinatal care of SLE patients，including guidelines，expert consensuses，systematic reviews，clinical decision-making，meta-analysis. The search period was from January 1，2011 to November 18，2021. The quality of the included literature was evaluated and the data were extracted by 2 researchers，and the evidence of the literature that met the criteria was summarized and integrated. Results A total of 10 articles were included，including 1 recommendation of clinical practice，4 guidelines，3 expert consensuses and 2 Meta-analysis. Finally，21 pieces of best evidence were formed，including planning pregnancy，monitoring and follow-up during pregnancy，medication management during pregnancy，lactation and neonatal management. Conclusion Nurses should make continuous and dynamic evaluation of SLE patients according to their clinical characteristics and working environment，and formulate treatment and nursing plans to improve maternal and infant outcomes and improve the quality of life of patients.

Key words: Systemic Lupus Erythematosus, Perinatal Period, Management, Summary of Evidence, Evidence-Based Nursing

王钰, 陈佳茵, 刘宁. 系统性红斑狼疮患者生育期保健的最佳证据总结[J]. 中华护理杂志, 2023, 58(4): 463-470.

WANG Yu, CHEN Jiayin, LIU Ning. Summary of the best evidence of perinatal care in patients with systemic lupus erythematosus[J]. Chinese Journal of Nursing, 2023, 58(4): 463-470.

图/表 3

表1 纳入文献的一般特征（n=10）

Table 1 Characteristics of included studies（n=10）

表2 纳入指南的质量评价结果（n=4）

Table 2 Quality evaluation of guidelines（n=4）

表3 系统性红斑狼疮患者生育期保健的最佳证据总结

Table 3 Summary of the best evidence for perinatal management of SLE patients

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