母乳喂养相关性乳头疼痛和创伤管理的最佳证据总结

Summary of best evidence for breastfeeding associated nipple pain and trauma management

目的 检索、评价国内外关于母乳喂养相关性乳头疼痛和创伤管理的相关证据,为临床实践提供参考.方法 按照证据金字塔"6S"证据模型,计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、澳大利亚乔安娜布里格斯研究所(JBI)、英国国家卫生与服务优化研究所(NICE)、美国国立临床诊疗指南数据库(NGC)、苏格兰联合指南网(SIGN)、加拿大安大略省注册护士协会网站(RNAO)、医脉通等网站或数据库中关于母乳喂养相关性乳头疼痛和创伤管理的所有证据,包括指南、证据总结、最佳临床实践手册、系统评价、专家共识及随机对照试验,检索时间为2012年1月1日—2022年6月1日.结果 共纳入22篇文献,其中指南5篇、证据总结3篇、系统评价6篇、专家共识1篇、RCT 7篇.从疼痛评估、教育与培训、非药物性干预措施、药物性干预措施、自我管理及注意事项6个方面总结了 26条证据.结论 本研究总结了母乳喂养相关性乳头疼痛和创伤管理的最佳证据,为规范母乳喂养相关性乳头疼痛和创伤管理提供了循证依据,建议护理人员在应用证据时综合考虑临床实际情况选择性应用最佳证据,延长母乳喂养时间、促进母婴健康.

Objective To retrieve and evaluate the evidence on breastfeeding associated nipple pain and trauma management both domestically and internationally,so as to provide reference for clinical practice.Methods According to the evidence pyramid"6S",all evidence on breastfeeding associated nipple pain and trauma management,including guidelines,evidence summary,best clinical practice manual,systematic review,expert consensus,and randomized controlled trial was retrieved by computer on China National Knowledge Infrastructure(CNKI),WanFang Data,VIP,China Biomedical Literature Database,PubMed,Embase,Web of Science,Cochrane Library,Joanna Briggs Institute(JBI)in Australia,National Institute for Health and Clinical Excellence(NICE),National Guideline Clearinghouse(NGC),Scottish Intercollegiate Guidelines Network(SIGN),Registered Nurses'Association of Ontario(RNAO),medlive and other websites or databases.The retrieval period was from January 1,2012 to June 1,2022.Results A total of 22 articles were included,including 5 guidelines,3 evidence summaries,6 systematic reviews,1 expert consensus and 7 RCTs.26 pieces of evidence were summarized from 6 aspects:pain assessment,education and training,non-pharmacological interventions,pharmacological interventions,self-management and precautions.Conclusions This study summarizes the best evidence for managing breastfeeding associated nipple pain and trauma,providing evidence-based evidence for regulating breastfeeding associated nipple pain and trauma management.It is recommended that nurses comprehensively consider the clinical situation when applying evidence,selectively apply the best evidence,extend breastfeeding time,and promote maternal and infant health.