不孕女性体外受精⁃胚胎移植周期治疗不良心理应激评估与干预的最佳证据总结

Best evidence summary for evaluation and intervention of psychological stress in infertile women with in vitro fertilization embryo transfer

目的:检索、评价并整合国内外关于不孕女性体外受精⁃胚胎移植周期治疗不良心理应激评估与干预的最佳证据。方法:系统检索指南库、专业学会及数据库中的指南、系统评价及原始研究,检索时限为建库至2022年12月15日,进行文献质量评价后,对证据进行提取和整合。结果:共纳入16篇文献,包括2篇指南、1篇专家共识、1篇Meta整合、6篇系统评价、6篇原始研究。总结了包括评估时机、评估工具、治疗前干预措施、治疗期间干预措施、治疗后失败干预措施、治疗后成功受孕干预措施6个方面的29条最佳证据。结论:医务人员应主动监测和精准识别不良心理应激高危人群,甄选可干预因素,确定最佳干预时机,制定相应的干预措施,根据本院实际情况将最佳证据总结应用于临床实践,以降低病人不良心理应激状态,提高其生育及生活质量,改善妊娠结局。

Objective:To retrieve,evaluate and integrate the best evidence of evaluation and intervention of psychological stress in patients in infertile women with in vitro fertilization embryo transfer.Methods:Guidelines,system evaluations,and original were researched from guide library,professional associations,and databases.The retrieval time was from the establishment of the database to December 15,2022.Evidence extraction and integration were carried out after evaluating the quality of literature.Results:16 articles were analyzed,including 2 guidelines,1 expert consensus,1 Meta⁃integration,6 systematic reviews and 6 randomized controlled trials,the 29 pieces of best evidence were summarized into 6 categories,including evaluation opportunity,evaluation tools,pre-treatment intervention measures,intervention measures during treatment,intervention measures after treatment failure,successful pregnancy after treatment intervention measures.Conclusion:Medical staffs should actively monitor and accurately identify high⁃risk groups of psychological stress,select the intervention factors,determine the best time for intervention,provide scientific evidence for making corresponding intervention measures,and application of the best evidence in clinical practice according to the actual situation of the hospital.In order to reduce the psychological stress of patients,improve their reproductive quality of life and improve the outcome of pregnancy.