妊娠晚期孕妇自数胎动方法的系统综述

Methods of Fetal Movement Self-counting in Late Trimester of Pregnancy:A Systematic Review

目的对妊娠晚期孕妇自数胎动方法进行系统综述。方法计算机检索Cochrane系统评价数据库、循证卫生保健中心(Joanna Briggs Institute,JBI)系统评价数据库、最佳实践指南(Best Practice)、安大略省注册护士协会(Registered Nurses’Association of Ontario,RNAO)、荷兰医学文摘数据库、护理学及医疗相关文献累计索引(cumulative index to nursing and allied health literature,CINAHL)、Pub Med、万方数据知识服务平台、中国生物医学文献数据库等9个数据库,收集妊娠晚期孕妇自数胎动方法的相关研究,根据纳入和排除标准筛选文献、提取资料及质量评价,并对文献进行定性分析。结果共纳入21篇文献,目前常用数胎动方法有时间固定法和胎动数固定法两类,对其具体方法、警戒值及处置方法进行总结比较后,发现两类方法的时间效率相当,而时间固定法敏感性较好,但假阳性率高。结论目前对于妊娠晚期孕妇自数胎动方法方面的研究已发表的高质量论文较少,提示应更新并发展我国临床实践中的自数胎动方法,协助孕妇选择适合自身的更准确、便捷的自数胎动方法,以提高孕妇自数胎动行为的依从性。

Obj ective To conduct a systemstic review on the fetal movement self-counting in late trimester of preg-nancy and the current application status.Methods Databases of Cochrane,JBI,Best Practice,RNAO,Embase,cumula-tive index to nursing and allied health literature（CINAHL）,PubMed,Wanfang,CBM and so on were searched.The relevant studies about fetal movement self-counting in late trimester of pregrancy were selected based on inclusion and exclusion criterias,and the literatures were analyzed.Results A total of 21 studies were included.The fixed-time fetal movement counting method and fixed-number counting method were analyzed.The specific method,sensitivity and nursing method were concluded.The time efficiency was equal,while the sensitivity was better in fixed-time method, but with high false positive rate.Conclusions Several kinds of fetal movement counting methods are recommended for pregnant women in late trimester to monitor fetus status.However there are some debates on different methods’sensi-tivity,specificity,compliance,and acceptance,which required further evidence.