Abstract:

Objective To select and obtain relevant evidence on postpartum optimal nursing management for older second-birth parturients,and summarize the best evidence. Methods Computer search of BMJ Best Practice,Joanna Briggs Institute Evidence-based Health Care Center Database,Up to date,Cochrane Library,British Guide Network,American Guide Network,China Guide Network,Evidence-based Medicine Database,PubMed,EMbase,Ontario Registered Nursing Association of Canada,China Biomedical Database,CNKI and American Association of Obstetricians and Gynaecologists was conducted for all relevant evidence on optimal maternal care and management,including guidelines,evidence summary,best clinical practice information sheet,systematic review,recommended practice and original research. Quality evaluation and data extraction of included literature were carried out by two researchers and documents that met quality standards were summarized. The retrieval period was from the establishment of the database to February 2019. Results A total of 15 documents including 6 guidelines,6 systematic reviews,1 cohort study and 2 randomized controlled trials were included. Totally 11 items of best evidence were summarized. Conclusion This study summarized the best evidence forolder second—birth parturients of postpartum optimal nursing and management. When applying evidence in clinical practice,it is necessary to carry out individualized evaluation of parturients. Attention should be paid to the renewal of the best evidence. Postpartum problems of second-birth parturients should be solved by scientific nursing approaches to improve quality of nursing.

Key words: Advanced Maternal Age, Second-Child, Pregnant Women and Puerpera, Optimized Care, Maternal Health Services, Evidence-Based Nursing

摘要：

目的 遴选并获取高龄二胎产妇产后优化护理及管理的相关证据,并总结最佳证据。方法 检索BMJ Best Practice、Joanns Briggs Institute（JBI）循证卫生保健中心数据库、UpTodate、 Cochrane图书馆、英国指南网、美国指南网、中国指南网、循证医学数据库、PubMed、EMbase、加拿大安大略注册护理协会网站、中国生物医学数据库、中国期刊全文数据库及美国妇产科医师协会网站关于产妇产后优化护理及管理的所有证据,包括指南、最佳临床实践、证据总结、系统评价、临床随机对照试验、类实验研究及队列研究。由2名研究人员分别对纳入文献的质量进行评价和资料提取,对符合标准的文献进行证据的总结和归纳。检索时限从建库至2019年2月。 结果 最终纳入15篇文献,包括6篇指南,6篇系统评价,1篇队列研究和2篇临床随机对照试验。总结了11条最佳证据。 结论 本研究总结了高龄二胎产妇产后优化护理及管理的最佳证据。临床应用证据时,需对产妇进行个体化评估,注重最佳证据的更新,以科学的护理方法解决高龄二胎产妇产后问题,提高护理质量。

关键词: 高龄, 二胎, 孕产妇, 优化护理, 产妇卫生保健服务, 循证护理学