妊娠期孕妇腕管综合征管理的最佳证据总结

Best evidence summary for management of carpal tunnel syndrome in pregnant women

目的检索并获取妊娠期孕妇腕管综合征管理的相关证据,为临床提供参考。方法在维普、万方、The Cochrane Library、PubMed、JBI等数据库系统检索妊娠期腕管综合征管理的相关文献,包括指南、证据总结、系统评价、Meta分析、专家共识、队列研究和随机对照试验,检索时限为建库至2023年4月。通过文献质量评价并结合专家意见进行证据推荐级别评定。结果共纳入16篇文献,包括6篇临床决策、3篇指南、3篇系统评价、1篇队列研究及3篇随机对照试验,总结出27条关于孕妇妊娠期腕管综合征的最佳证据,包括症状评估与临床诊断、风险因素、处理的基本原则、非药物治疗和药物治疗5个方面。结论该研究总结归纳并形成了妊娠期腕管综合征的管理方案,证据归纳转化时应充分考虑孕产妇的意愿、实际的临床经验、根据病情轻重对症治疗,从多方面考虑选择最佳证据,帮助临床医护人员指导患者降低妊娠期腕管综合征发生率、动态评估并选择最佳方案治疗妊娠期腕管综合征。

Objective To retrieve and collect evidence of the management of carpal tunnel syndrome in pregnant women,and to provide reference for clinical practice.Methods Evidence-based literature on the management of carpal tunnel syndrome during pregnancy were retrieved from databases of VIP,Wangfang,The Cochrane Library,PubMed,JBI,including guidelines,evidence summary,systematic review,meta-analysis,expert consensus cohort studies and randomized controlled trials.The retrieval period was from the inception of the databases to April 2023.Through literature quality evaluation and expert opinion,the level of evidence recommendation was evaluated.Results Sixteen articles are collected,including 6 pieces of clinical decision-making,3 guidelines,3 pieces of systematic review,1 cohort study and 3 pieces of randomized controlled trials.Twenty-seven pieces of best evidence were summarized into five aspects of assessment and diagnosis,risk factors,principles of management,non-drug therapy and drug therapy.Conclusion This study summarizes and forms the management program of carpal tunnel syndrome during pregnancy.The will of pregnant women,clinical experience,and symptomatic treatment according to the severity of the disease should be fully considered in the transformation of evidence,and the best evidence should be selected from many aspects,so as to help clinical medical staff guide patients to reduce the incidence of carpal tunnel syndrome in pregnant women,dynamically evaluate and select the best treatment for carpal tunnel syndrome during pregnancy.