Abstract:

Objective To retrieve the best evidence of management of non-pharmacological labor analgesia for women with trial of labor. Methods We systematically searched National Institute for Health and Clinical Excellence（NICE）,American College of Obstetricians and Gynecologists（ACOG）,the Society of Obstetricians and Gynecologists of Canada（SOGC）,Guidelines International Network（GIN）,Joanna Briggs Institute（JBI）,Uptodate,Cochrane Library,CNKI,Wanfang Database,Pubmed to collect guidelines,best practices,expert consensuses. The retrieval period was from January 2014 to September 2019. 2 researchers with evidence-based nursing background assessed the quality of the literature independently and extracted the evidence. Result A total of 12 articles were included,including 1 clinical guideline,2 clinical decisions,5 systematic reviews and 4 evidence summaries. 33 pieces of evidence were obtained,including the implementation timing,supportive environment,accompany delivery,cold and hot compress,breathing and relaxation techniques,transcutaneous electrical nerve stimulation,water labor,touching and massage,posture and activity. Conclusion This study summarized the best evidence of management of non-pharmacological labor analgesia for women with trial of labor,which can provide evidence-based practice bases for standardized management of non-pharmacological labor analgesia in maternity settings.

Key words: Non-Pharmacological Labor Analgesia, Labor Management, Perinatal Period, Evidence-Based Nursing, Evidence Summary

摘要：

目的 检索、评价和总结非药物性分娩镇痛在阴道试产产妇产程管理中的证据。 方法 系统检索英国国家临床优化研究所网站、美国妇产科医师学会网站、加拿大妇产科医师学会网站、国际指南协作网、乔安娜布里格斯研究所循证卫生保健图书馆、UpToDate、Cochrane图书馆、中国知网、万方、Pubmed等国内外数据库和网站关于非药物性分娩镇痛在阴道试产产妇产程管理的证据,包括临床决策、指南、系统评价、专家共识等。检索时限为2014年1月—2019年9月。由2名研究员独立进行文献评价,对符合标准的文献进行资料提取。 结果 共纳入12篇文献,包括1篇指南、2篇临床决策、5篇系统评价、4篇证据总结,包括非药物分娩镇痛的疼痛评估与实施时机、支持性环境、陪伴分娩、冷热敷、呼吸与放松技术、经皮神经电刺激疗法、水中待产、抚触按摩、活动与体位9个方面,共33条证据。 结论 该研究总结了非药物性分娩镇痛在阴道试产产妇产程管理中的证据,可为助产机构实施非药物性分娩镇痛的规范化管理提供依据。

关键词: 非药物性分娩镇痛, 产程管理, 围产期, 循证护理, 证据总结