目的检索并总结新生儿戒断综合征评估与管理的最佳证据。方法计算机检索BMJ Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、国际指南协作网、美国国立指南库、英国国家...目的检索并总结新生儿戒断综合征评估与管理的最佳证据。方法计算机检索BMJ Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、国际指南协作网、美国国立指南库、英国国家卫生与临床优化研究所、美国儿科学会网站、加拿大药理学和治疗学学会网站、Cochrane Library、PubMed、医脉通、中国知网、万方数据库及维普网等数据库中关于新生儿戒断综合征评估与管理的证据。检索时限为建库至2022年12月31日。由2名研究者对相关文献进行独立质量评价,并对符合质量标准的文献进行证据提取和汇总。结果共纳入11篇文献,包括证据总结1篇、临床决策1篇、指南4篇、系统评价5篇。从新生儿戒断综合征的评估、非药物干预措施、药物干预措施、出院及随访、团队组建与培训等5个方面汇总了19条最佳证据。结论总结的新生儿戒断综合征评估与管理的最佳证据可为医护人员提供循证依据。展开更多
Objective:To compare the prevalence and clinical characteristics of neonatal abstinence syndrome in neonates exposed and not exposed to selective serotonin r euptake inhibitors(SSRIs)in utero.Design:Cohort study.Setti...Objective:To compare the prevalence and clinical characteristics of neonatal abstinence syndrome in neonates exposed and not exposed to selective serotonin r euptake inhibitors(SSRIs)in utero.Design:Cohort study.Setting:Tertiary car e center.Patients:One hundred twenty term infants,of whom 60 had prolonged in utero exposure to SSRIs,including paroxetine hydrochloride,fluoxetine,citalo pram hydrobromide,sertraline hydrochloride,and venlafaxine hydrochloride.Main Outcome Measures:Neonatal abstinence syndrome was assessed with the Finnegan s core as follows:score of 8 or above,severe;score of 4 to 7,mild;and score o f 0 to 3,normal.All infants were followed up with a standardized protocol that included repeated Finnegan score assessments and cardiorespiratory monitoring u ntil normalization of the Finnegan score.Results:Of the 60 neonates exposed to SSRIs in utero,8 showed severe and 10 showed mild symptoms of a neonatal absti nence syndrome.All nonexposed neonates had a normal Finnegan score.In neonates who developed severe symptoms,the maximum mean daily Finnegan scores were reco rded within 2 days after birth,although maximum individual scores were recorded as long as 4 days after birth.Conclusions:Neonatal abstinence syndrome occurs in 30%of neonates exposed to SSRIs in utero.These neonates should be monitore d for at least 48 hours after birth.The longterm effects of prolonged exposure to SSRIs,particularly in neonates who develop severe symptoms,have yet to be d etermined.展开更多
文摘Objective:To compare the prevalence and clinical characteristics of neonatal abstinence syndrome in neonates exposed and not exposed to selective serotonin r euptake inhibitors(SSRIs)in utero.Design:Cohort study.Setting:Tertiary car e center.Patients:One hundred twenty term infants,of whom 60 had prolonged in utero exposure to SSRIs,including paroxetine hydrochloride,fluoxetine,citalo pram hydrobromide,sertraline hydrochloride,and venlafaxine hydrochloride.Main Outcome Measures:Neonatal abstinence syndrome was assessed with the Finnegan s core as follows:score of 8 or above,severe;score of 4 to 7,mild;and score o f 0 to 3,normal.All infants were followed up with a standardized protocol that included repeated Finnegan score assessments and cardiorespiratory monitoring u ntil normalization of the Finnegan score.Results:Of the 60 neonates exposed to SSRIs in utero,8 showed severe and 10 showed mild symptoms of a neonatal absti nence syndrome.All nonexposed neonates had a normal Finnegan score.In neonates who developed severe symptoms,the maximum mean daily Finnegan scores were reco rded within 2 days after birth,although maximum individual scores were recorded as long as 4 days after birth.Conclusions:Neonatal abstinence syndrome occurs in 30%of neonates exposed to SSRIs in utero.These neonates should be monitore d for at least 48 hours after birth.The longterm effects of prolonged exposure to SSRIs,particularly in neonates who develop severe symptoms,have yet to be d etermined.
