年轻乳腺癌患者生育指导的最佳证据总结

Best evidence summary for the fertility guidance in young breast cancer patients

目的 评价并总结年轻乳腺癌患者生育指导的相关证据,为医护人员对年轻乳腺癌患者开展生育指导提供依据。方法 系统检索UpToDate、BMJ Best Practice、Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家卫生与临床优化研究所、国际指南网、苏格兰学院间指南网、美国国立指南网、加拿大安大略省注册护士协会、医脉通、中国指南网、美国国立综合癌症网络、美国临床肿瘤协会、欧洲临床肿瘤协会、美国癌症协会、中国抗癌协会、中华护理学会、PubMed、Web of Science、CINHAL、Trip Medical Database、Clinical Trials、Open Grey、Grey Guide、中国知网、万方医学网、维普数据库、中国生物医学文献服务系统等网站或数据库中关于年轻乳腺癌患者生育指导的临床决策、指南、系统评价、证据总结和专家共识等证据,检索时限为建库至2021年11月,由2名具有循证护理研究背景的研究者独立完成文献的质量评价,并结合专业人士的意见,对符合质量标准的文献进行证据提取及总结。结果 共纳入9篇文献,包括1篇临床决策、1篇指南、1篇系统评价、6篇专家共识。总结的最佳证据包括生育评估、生育力保存、生育时机、抗肿瘤治疗与生育、哺乳指导、避孕措施、生育与生存情况7个方面的24条最佳证据。结论 该研究总结的最佳证据可为临床医护人员开展年轻乳腺癌患者生育指导提供依据。在临床应用时,医护人员需结合临床情境,充分考虑患者意愿,促进患者获益最大化,以进一步提高患者的生活质量。

Objective To evaluate and summarize the evidence of pregnancy guidance for young breast cancer patients,and provide the basis for medical staff to provide pregnancy guidance. Methods The guidelines,expert consensuses,evidence summaries,clinical decisions and systematic evaluations of pregnancy guidance of breast cancer patients were systematically searched from BMJ Best Practice,Up To Date,Cochrane Library,JBI,Pubmed,CINAHL,Embase,US National Guidelines Library,International Guidelines Collaborative Network,Scottish Intercollegiate Guidelines Network,Canadian Ontario Registered Nurses Association website,Web of Science,Yimai Tong,China Guidelines.com,CNKI,Wanfang Medical Network,China Biomedical Literature Service and VIP database from the establishment of the database to November 2021. There were 2 researchers with evidence-based nursing research background who independently completed the quality evaluation of the literature,and combined with the opinions of professionals to extract and summarize the literature that met the quality standards. Results A total of9 articles were included,including 1 clinical decision,1 guideline,1 systematic evaluation and 6 expert consensuses. Conclusion This study summed the best evidence to provide pregnancy guidance to young breast cancer patients. In clinical practice and application,healthcare professionals need to take the clinical context into account and fully consider the patient’s wishes to maximize patient benefits,in order to further improve the quality of life of patients.