妊娠期糖尿病孕妇运动方案的最佳证据总结

Evidence summary of exercise regimens for patients with gestational diabetes mellitus

目的检索、评价和整合妊娠期糖尿病孕妇运动方案的最佳证据,为临床护理实践提供依据。方法计算机检索BMJ Best Practice、UpToDate、国际指南协作网、加拿大安大略注册护士协会网站、美国糖尿病协会网站、中国医脉通指南网、Cochrane Library、PubMed、中国知网、万方知识数据服务平台等数据库、指南网以及专业协会网站关于妊娠期糖尿病孕妇运动方案的所有证据,包括指南、系统评价、证据总结、推荐实践和专家共识,检索时限为建库至2019年5月。采用乔安娜布里格斯研究所循证卫生保健中心的文献评价标准和证据分级系统,对研究进行文献质量评价及证据级别评定。结果共纳入文献16篇,从妊娠期糖尿病孕妇运动方案适用人群、运动获益、运动风险、运动评估、运动方式、运动强度、运动时间和注意事项8个方面汇总31条最佳证据。结论妊娠期糖尿病孕妇适度运动是安全有效的,临床护士可以通过应用最佳证据指导妊娠期糖尿病孕妇孕期合理运动,提高护理干预的科学性。

Objective To retrieve,appraise and integrate the available evidence of exercise regimens for gestational diabetes mellitus patients,and to provide foundation for decision-making in clinical nursing practice.Methods We searched the BMJ Best Practice,UpToData,Guidelines International Network(GIN),Registered Nurses’Association of Ontario(RNAO),American Diabetes Association(ADA),Chinese Medlive Guidelines Network,Cochrane Library,PubMed,CNKI,Wanfang Date to collect all articles on exercise regimens for gestational diabetes mellitus,including guidelines,systematic reviews,evidence summaries,recommended practice and expert consensuses.The retrieval period was from the inception to May 2019.JBI evidence appraisal and recommendation system was used to evaluate quality of studies and level of evidence.Results Totally 16 articles were selected,and a total of 31 items of best evidence were summarized from 8 aspects,including applicable population of gestational diabetes exercise interventions,benefits,risks,assessments,types,intensity,time and precautions.Conclusion Moderate exercise is safe and effective for patients with gestational diabetes.Clinical nurses should guide patients to exercise moderately during pregnancy by applying the best evidence with scientific nursing intervention.