妊娠早中期药物流产病人疼痛管理的最佳证据总结

Summary of the best evidence for pain management in patients with medical abortion in first and second trimester of pregnancy

目的:评价总结妊娠早中期药物流产病人疼痛管理的最佳证据,为妊娠早中期药物流产病人疼痛管理提供证据支持。方法:根据问题开发工具PIPOST确立妊娠早中期药物流产病人疼痛管理的循证问题,检索Up to Date临床决策系统、Joanna Briggs循证卫生保健国际合作中心图书馆、医脉通、美国指南网、加拿大指南网、the Cochrane Library、PubMed、万方数据库、中国知网中关妊娠早中期药物流产病人疼痛管理的临床实践指南、临床决策、证据总结、系统评价及随机对照试验,检索时间为建库至2019年5月31日,由2名研究者对文献质量进行评价,并进行证据总结。结果:共纳入7篇文献,其中指南2篇,临床决策4篇,系统评价1篇。汇总出疼痛评估与记录、疼痛处理、疼痛教育三大类别,20条证据。结论:汇总的20条妊娠早中期药物流产病人疼痛管理证据支持强,可在临床应用,医护人员在应用证据时结合临床情境和障碍因素,制定疼痛管理策略,评价镇痛效果,降低妊娠早中期药物流产病人疼痛水平,提高病人对疼痛控制的满意度。

Objective:To evaluate and summary the best evidence for pain management in patients with medical abortion in the first and second trimester of pregnancy,and to provide evidence support for pain management in patients with medical abortion in the first and second trimester of pregnancy.Methods:Based on the problem development tool PIPOST to establish evidence-based problems for pain management in patients with medical abortion in the first and second trimester of pregnancy,clinical practice guidelines,clinical decision-making,summary of evidence,systematic review and randomized controlled trials on pain management in patients with medical abortion in first and second trimester of pregnancy were searched from the Up to Date clinical decision system,the Joanna Briggs Library of Evidence-Based International Healthcare Centers,Chinese Clinical Guide Library,American Guide Network,the Cochrane Library,PubMed,WanFang database and CNKI.The retrieval time was from the establishment of the database to 31 July,2019.Evaluation of the quality of the literatures and evidence summary were performed by tuo researchers.Results:A total of 7 literatures were included,including 2 guidelines,4 clinical decisions,and 1 systematic review.Three categories were summarized.They were of pain assessment and recording,and pain management,and pain education,involving a total of 20 pieces of evidence.Conclusion:There is strong evidence for pain management in patients with medical abortion in the first and second trimester of pregnancy,which can be used in clinical application.Medical staff should combine clinical situations and obstacle factors during the application of evidence,so as to formulate pain management strategies,evaluate the analgesic effect,and reduce pain levels in patients with medical abortion in the early and second trimester,which can improve patient satisfaction with pain control.