妊娠期糖尿病孕妇饮食管理的证据总结

Evidence summary of diet management for patients with gestational diabetes mellitus

目的检索并评价妊娠期糖尿病孕妇饮食管理的相关证据,为临床护理实践提供依据。方法计算机检索BMJ Best Practice、JBI、UpToDate、Cochrane Library、国际指南协作网、中国知网、医脉通等国内外数据库中所有关于妊娠期糖尿病孕妇饮食管理的证据,检索时限为建库至2021年2月。由2名研究者使用临床指南研究与评价系统对指南进行质量评价,使用多重系统评价评估工具对系统评价进行质量评价,使用JBI循证卫生保健中心对应的评价标准(2016)对临床决策进行质量评价,使用JBI循证卫生保健中心的专家意见和专家共识类的文献质量评价工具对专家共识进行评价,并进行证据提取及汇总。结果共纳入13篇文献,其中临床实践指南8篇,系统评价3篇,临床决策1篇,专家共识1篇。经过评价,从妊娠期糖尿病孕妇饮食管理的目标、评估、体质量管理、营养素推荐、饮食结构、健康教育6个方面总结出27条证据。结论本研究总结了妊娠期糖尿病孕妇饮食管理的最佳证据,为临床护理人员对妊娠期糖尿病孕妇进行饮食管理提供了循证依据。但由于本研究总结的证据来自多个国家,护理人员在应用时应充分评估临床情境,结合孕妇的饮食习惯及偏好,为其制订个性化的饮食管理方案。

Objective To search and evaluate the relevant evidence of diet management for pregnant women with gestational diabetes mellitus(GDM).Methods We searched the literatures on the diet management for pregnant women with GDM in the following databases:BMJ Best Practice,JBI,UpToDate,Cochrane Library,GIN,CNKI,and Medlive from their inception to February 2021.Two researchers used AGREEⅡ,AMSTAR and JBI Evidence-based Health Care Center evaluate standards(2016)and expert concensus for quality evaluation and conducted data extraction.Results Totally 13 papers were selected,including 8 clinical practice guidelines,3 systematic reviews,1 clinical decision and 1 expert consensus.A total of 27 items of best evidence were summarized from 6 aspects including diet management goal,evaluation,BMI management,nutrient,diet structure and health education.Conclusion This study summarizes the best evidence of dietary management for pregnant women with GDM.As evidence summarized in this study from several countries,nurses should fully evaluate the clinical situation and formulate individualized diet management schedule for pregnant women with GDM with the consideration of their eating habits and preferences.