产妇产程中经口摄入能量管理的最佳证据总结

Evidence summary for oral intake management during labor

目的检索、评价和汇总产妇产程中经口摄入能量管理的最佳证据,为开展临床实践提供参考。方法根据证据资源“6S”模型,检索计算机决策系统、指南网站、专业协会网站和数据库中关于产妇产程中经口摄入能量管理的证据,包括临床决策、最佳实践、指南、证据总结、专家共识和系统评价等,检索时限为建库至2021年12月,补充检索2018年1月—2021年12月发表的随机对照试验。由2名研究员对文献进行方法学质量评价,对符合标准的文献进行资料提取与证据汇总。结果共纳入12篇文献,包括临床决策1篇、指南5篇、证据总结1篇、专家共识3篇和随机对照试验2篇,从健康教育、产时动态评估、产程中经口摄入能量的推荐方案和系统支持4个方面总结了19条最佳证据。结论该研究总结了产妇产程中经口摄入能量管理的最佳证据,可为临床开展循证实践提供依据。医护人员应将最佳证据与临床情景、专家判断及产妇意愿相结合,为不同人群制订个性化的产程中经口摄入能量管理方案,从而保证在能量供应、改善母婴分娩结局的同时提高产妇进食满意度、缓解情绪压力。

Objective To search,evaluate and summarize the best evidence of oral intake management during labor and to provide references for clinical practice.Methods According to the“6S”model of evidence resources,clinical decision support,best practice recommendations,guidelines,evidence summaries,expert consensuses and systematic reviews related to oral intake management published in computer decision support systems,guideline websites,association official websites and databases were searched from the establishment of databases to December 2021.A supplementary search was performed for randomized controlled trials published between January 2018 and December 2021.2 researchers evaluated the methodological quality of the literature,extracted and summarized evidence according to the subject.Results A total of 12 articles were included,including 1 clinical decision support,5 guidelines,1 evidence summary,3 expert consensuses and 2 randomized controlled trials,and 19 pieces of best evidence were summarized from 4 aspects of health education,dynamic evaluation during labor,recommended schemes of oral intake during labor and systematic support.Conclusion This study summarized the best evidence of oral intake management during labor,which can provide a basis for clinical evidence-based practice.Healthcare professionals should combine the best evidence with clinical situation,expert judgment and maternal wishes to develop personalized oral intake management programs during labor for different groups,so as to ensure energy supply,improve maternal and child delivery outcomes,while improving maternal food satisfaction and relieving emotional stress.