非药物干预措施对围产期丧失胎儿或新生儿女性负性情绪改善效果的网状Meta分析

doi:10.3761/j.issn.0254-1769.2025.24.017

摘要/Abstract

摘要：

目的系统评价不同非药物干预措施对围产期丧失胎儿或新生儿（以下简称“围产期丧失”）女性负性情绪的改善效果，旨在为临床护理实践提供循证依据。方法系统检索PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普数据库、万方数据库、中国生物医学文献服务系统等数据库中与围产期丧失相关的随机对照试验，检索时限为2014年1月—2025年1月，由2名研究者独立阅读并筛选文献、提取数据资料及评价纳入研究的质量。使用Stata 18.0软件进行网状Meta分析。结果最终纳入17篇文献，涉及3 120例围产期丧失女性，网状Meta分析结果显示：与常规护理相比，心理咨询、正念疗法、经皮电刺激、音乐疗法、认知行为疗法、支持性照护、丧葬干预、瑜伽对围产期丧失女性负性情绪均具有改善作用（P<0.05），根据累积排序概率曲线下面积结果，心理咨询改善效果最佳。结论心理咨询在围产期丧失女性负性情绪改善中效果最好，可作为临床干预的优先选择。

关键词: 围产期丧失, 焦虑, 抑郁, 悲伤, 非药物治疗, 网状Meta分析, 产科护理, 循证护理学

Abstract:

Objective To systematically evaluate the effectiveness of different non-pharmacological interventions to improve negative emotions in women with perinatal loss of the fetus or newborn（hereinafter referred to as “perinatal loss”），with the aim of providing an evidence-based basis for clinical nursing practice. Methods Databases including PubMed，Cochrane Library，Embase，Web of Science，CNKI，VIP，Wanfang Data，and CBM were systemati-cally searched for randomized controlled trials（RCTs） involving women with perinatal loss，covering the period from January 2014 to January 2025. Totally 2 investigators independently screened studies，extracted data，and assessed risk of bias in included trials. Network meta-analyses were conducted using Stata 18.0 software. Results A total of 17 randomized controlled trials involving 3，120 women with perinatal loss were included. Network meta-analysis revealed that compared to routine care in the control group，8 interventions—psychological counseling，mindfulness therapy，transcutaneous electrical stimulation，music therapy，cognitive behavioral therapy，supportive care，funeral and Yoga—significantly alleviated negative emotions（P<0.05）. Psychological counseling demonstrated optimal efficacy based on surface under the cumulative ranking curve analysis. Conclusion Psychological counseling demonstrates optimal efficacy in alleviating negative emotions among women experiencing perinatal loss and should be prioritized as a primary clinical intervention option.

Key words: Perinatal Loss, Anxiety, Depression, Grief, Non-Pharmacological Therapy, Network Meta-Analysis, Obstetrical Nursing, Evidence-Based Nursing

汪秀娟, 付文君, 聂林涛, 王若茗, 李亚丽, 丁娟, 马啸, 李臻. 非药物干预措施对围产期丧失胎儿或新生儿女性负性情绪改善效果的网状Meta分析[J]. 中华护理杂志, 2025, 60(24): 3052-3058.

WANG Xiujuan, FU Wenjun, NIE Lintao, WANG Ruoming, LI Yali, DING Juan, MA Xiao, LI Zhen. Efficacy of non-pharmacological interventions for mitigating negative emotions in women with perinatal loss of fetus or newborns：a network Meta-analysis[J]. Chinese Journal of Nursing, 2025, 60(24): 3052-3058.

图/表 4

表1 PubMed的检索策略

Table 1 Search strategies for PubMed

表2 纳入文献的基本特征（n=17）

Table 2 Baseline characteristics of included studies（n=17）

图1 网状Meta分析证据网络

Figure 1 Network geometry of the network Meta-analysis

图2 非药物干预措施对围产期丧失女性负性情绪干预效果的联赛表[SMD（95%CI）]

Figure 2 League table of non-pharmaceutical intervention effects on negative emotions in perinatal loss[SMD（95%CI）]

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