非药物干预促进妇科术后病人胃肠功能恢复的最佳证据总结

Summary of the best evidence for non-pharmacological interventions to restore gastrointestinal function after surgery in gynecological patients

目的:总结非药物干预促进妇科术后病人胃肠功能恢复的最佳证据,为完善妇科术后病人胃肠功能恢复的管理提供参考。方法:根据“6S”证据模型,检索UpToDate、BMJ Best Practice、英国国家医疗保健优化研究所、加拿大安大略注册护士协会、医脉通指南网、美国麻醉医师学会、中华医学会麻醉学分会官网、the Cochrane Library、PubMed、EMbase、Scopus、中国生物医学文献服务系统、中国知网、万方等数据库中关于非药物干预促进妇科术后病人胃肠功能恢复的所有证据,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2023年3月22日。由2名研究人员独立进行文献质量评价,4名研究人员进行证据提取、翻译及整合。结果:共纳入29篇文献,其中临床决策6篇、指南2篇、专家共识7篇、系统评价14篇。总结了术后早期提供肠内营养、术后早期活动、饮用咖啡、咀嚼口香糖、中医技术、健康教育6个方面共18条最佳证据。结论:总结的证据可为临床医护人员开展非药物干预促进妇科术后病人胃肠功能恢复的管理实践提供依据。临床应用时,需充分考虑临床情景,结合专业人士的判断及病人的意愿,遵循个体化原则,分析证据应用的障碍因素及促进因素,审慎地将证据应用于临床实践中。

Objective:To summarize the best evidence of non-pharmacological intervention for postoperative gastrointestinal function recovery in gynecological patients and to provide a reference for improving the management of non-pharmacological intervention for postoperative gastrointestinal function recovery in gynecological patients.Methods:Based on the"6S"evidence model,clinical decision-making,best practices,guidelines,evidence summary,expert consensus,and systematic reviews on non-pharmacological interventions for postoperative gastrointestinal function recovery in gynecological patients were retrieved from UpToDate,BMJ Best Practice,the British National Institute for Healthcare Excellence,the Ontario Registered Nurses Association of Canada,Yimaitong Guide Network,the American Society of Anesthesiologists,the official website of the Anesthesia Branch of the Chinese Medical Association,and the Cochrane Library,PubMed,EMbase,Scopus,Chinese Biomedical Literature Service System,China National Knowledge Infrastructure(CNKI),WanFang Database,etc.The search time was limited from establishing the database to March 22,2023.Two researchers independently conducted the literature quality assessment;four researchers conducted evidence extraction,translation,and integration.Results:A total of 29 documents were included,including 6 clinical decision-making articles,2 guidelines,7 expert consensus articles,and 14 systematic reviews.A total of 18 pieces of best evidence were summarized in 6 aspects:providing enteral nutrition in the early postoperative period,early postoperative activities,drinking coffee,chewing gum,traditional Chinese medicine technology,and health education.Conclusion:The summarized evidence could provide a basis for clinical medical staff to perform non-pharmacological intervention management practices for postoperative gastrointestinal function recovery in gynecological patients.During clinical application,it is necessary to fully consider the clinical scenario,combine the judgment of professionals and the wishes of the patient,follow the principle of individualization,analyze the obstacles and facilitators to the application of evidence,and prudently apply the evidence to clinical practice.