宫腔内人工授精术后卧床指导的最佳证据总结

Summary of the best evidence for bed guidance after artificial insemination in the uterine cavity

目的检索、评价与整合有关宫腔内人工授精术后卧床指导的相关证据,并对最佳证据进行总结,为护理临床实践提供依据。方法遵循循证护理的方法,针对宫腔内人工授精术后卧床指导提出循证问题,检索宫腔内人工授精术后卧床的相关证据,包括指南、系统评价、最佳实践、证据总结与专家共识等,检索时限为建库起至2021年3月25日。采用JBI循证卫生保健中心的文献质量评价标准和证据分级系统,2名循证小组成员对检索到的文献进行评价及分级。结果本研究共纳入6篇文献,其中包含3篇证据总结、2篇系统评价和1篇专家推荐,从宫腔内人工授精术后的卧床时间、卧床体位及活动宣教3个方面总结出最佳证据,建议对于首次行宫腔内人工授精术的不孕症患者术后采用抬高臀部仰卧位休息10~15 min,离院后无需增加卧床时间,该措施在不影响人工授精成功率前提下,可提高治疗室周转率。对出现腹痛及阴道流血等术后并发症的患者可延长卧床时间,增加观察次数。结论生殖中心完善人工授精术后相关流程,根据患者的具体情况给予合适的卧床指导,由于最新证据随着时间推移不断更新,使用者需根据所在医院的特点和临床环境,有针对性的选择最佳证据。

Objective To retrieve,evaluate,and integrate relevant evidence on the guidance of bedtime after artificial insemination in the uterine cavity,and to summarize the best evidence to provide a basis for clinical practice of nursing.Methods Following the method of evidence-based nursing,evidence-based questions was put forward on the guidance of bed-based post-in vitro insemination,and retrieves relevant evidence of bed-in-bed after artificial insemination in the uterine cavity,including guidelines,systematic evaluation,best practices,summary of evidence,and expert consensus,etc.,and the search time limit was from the establishment of the library until March 25,2021.Using the document quality evaluation standard and evidence grading system of JBI Evidence-Based Health Care Center,2 researchers evaluated and graded the retrieved literature.Results This study was included in 6 literatures,including 3 evidence summary,2 systematic evaluation,1 expert recommendation,and the best evidence were summarized from 3 aspects,bed time after artificial insemination in the uterine cavity,bed position,and activity education.A measure was recommended that the first time infertility patients with insemination in the uterine cavity after surgery use a 10-15 min rested with elevated hips,and had no need to increase bed time after leaving the hospital,which could improve the turnover rate of the treatment room without affecting the success rate of artificial insemination.For patients with postoperative complications such as abdominal pain and vaginal bleeding,bed time could be longer and the number of observation could be increased.Conclusion The reproductive center improves the process of artificial insemination,and gives appropriate bed time guidance according to the patient's specific situation.As the latest evidence was updated over time,the user needed to select the best evidence according to the characteristics of the hospital and clinical environment.