宫颈癌患者术后及放疗后性问题评估与干预的最佳证据总结

Best evidence summary for evaluation and intervention of sexual problems in patients with cervical cancer after surgery and radiotherapy

目的检索、评价并总结宫颈癌患者术后及放疗后性问题评估及干预的最佳证据。方法计算机检索Up To Date、英国医学杂志最佳临床实践(British Medical Journal Best Practice,BMJ-BP)、国际指南协作网(Guideline international network,GIN)、美国国立指南文库(National guideline clearinghouse,NGC)、医脉通、科克伦图书馆(Cochrane Library)、科学网(Web of Science)、PubMed、CINAHL、EMBASE、中国生物医学数据库(Chinese Biomedical database,CBM)、中国知网(China National Knowledge Infrastructure,CNKI)、万方及维普(VIP)自建库至2021年7月关于宫颈癌患者术后及放疗后性问题评估及干预的的临床实践指南、证据总结、实践推荐、系统评价、随机对照试验(Randomized Controlled Trial,RCT)及专家共识。结果共纳入12篇文献,包括指南3篇、指南更新1篇、系统评价2篇、RCT 5篇、专家意见1篇。从评估、改善阴道干涩/性交疼痛、降低性反应困难、提高整体性功能和满意度及改善放疗后阴道狭窄5个方面总结出27条证据。结论该证据总结可为医护人员为宫颈癌患者进行性问题评估与干预时提供循证支持,但用证者应结合临床情境及宫颈癌患者的特点,以早期识别和解决宫颈癌患者的性问题。

Objective To search,evaluate and summarize the best evidence for evaluation and intervention of sexual problems in patients with cervical cancer after surgery and radiotherapy.Methods Such databases as Up to Date,The Best Clinical Practice of BMJ,G-I-N,NGC,Yimaitong,Cochrane Library,Web of Science,PubMed,CINAHL,EMBASE,CBM,CNKI,Wanfang and VIP were searched up to July 2021 for clinical practice guidelines,evidence summary,recommended practice,systematic review,RCT and expert consensus about the intervention strategies for sexual problems in patients with cervical cancer after surgery and radiotherapy.Results A total of 12 literatures were selected,including 3 guidelines,1 guideline update opinion,2 systematic reviews,5 RCTs and 1 expert consensus.Totally 27 pieces of evidence on 5 aspects including evaluation,improving vaginal dryness/sexual pain,reducing sexual response difficulty,improving overall sexual function and satisfaction,and improving vaginal stenosis after radiotherapy were finally summarized.Conclusion This evidence summary can provide evidence-based support for medical staff to evaluate and intervene the sexual problems of cervical cancer patients,however,the user should combine the clinical situation and the characteristics of cervical cancer patients to identify and solve the sexual problems of cervical cancer patients at an early stage.