作者：李唱，盖莹，姜海龙，王书培，耿小婷，李淑英

单位：

1.067000河北省承德市，承德医学院护理学院 2.067000河北省承德市，承德医学院附属医院护理部

Units：

1.School of Nursing, Chengde Medical University, Chengde 067000, China2.Department of Nursing, Affiliated Hospital of Chengde Medical University, Chengde 067000, China

关键词：

高血压，妊娠性；生活方式；循证医学；证据

Keywords：

Pregnancy-induced hypertension; Life style; Evidence-based medicine; Evidence

CLC：

R 714.246

DOI：

10.12114/j.issn.1008-5971.2023.00.238

Funds：

2021年度河北省医学科学研究课题计划（20210245）

摘要：

目的　总结妊娠期高血压患者生活方式管理的最佳证据。方法　按照“6S”循证资源金字塔模型，采用计算机检索决策系统（包括UpToDate、BMJ Best Practice）、指南网站〔包括国际指南协作网（GIN）、美国国立指南库（NGC）、加拿大安大略注册护士协会（RNAO）、英国国家卫生与临床优化研究所（NICE）、WHO指南网、医脉通网站〕、专业学术网站〔包括美国妇产科医师协会（ACOG）、加拿大妇产科医生协会（SOGC）、美国心脏协会（AHA）、欧洲心脏病学会（ESC）、澳大利亚和新西兰产科医学会（SOMANZ）网站〕、数据库（包括JBI、Web ofScience、Ovid、Embase、Cochrane Library、PubMed、中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普网）公开发表的妊娠期高血压生活方式管理相关文献。检索时限为2010年1月至2023年2月。由两名研究者独立评价纳入文献的质量，提取并汇总证据。结果　共纳入10篇文献，包括指南4篇、专家共识1篇、临床决策1篇、系统评价2篇、RCT 2篇。4篇指南中2篇推荐级别为A级、2篇推荐级别为B级；1篇专家共识的质量评价总分＞5.0分；1篇临床决策提取的证据来自2篇队列研究（质量评价总分均为9.0分）；2篇系统评价的质量评价总分均≥9.0分；2篇RCT中，ADEL等研究除条目8为“不清楚”外，其余条目均为“是”，侯艳梅研究除条目4和条目5为“不清楚”外，其余条目均为“是”。通过证据提取与整合，最终形成了妊娠期高血压患者生活方式管理的最佳证据，包括管理时机、饮食管理、运动管理、行为管理4个维度共21个条目。结论　该研究总结了包括管理时机、饮食管理、运动管理、行为管理4个维度共21个条目的妊娠期高血压患者生活方式管理的最佳证据，为妊娠期高血压患者制定个性化管理方案提供了借鉴。

Abstract：

Objective To summarize the best evidence of lifestyle management in patients with pregnancy-inducedhypertension. Methods According to the "6S" evidence-based resource pyramid model, the literature on lifestyle managementof pregnancy-induced hypertension published in decision system (including UpToDate, BMJ Best Practice) , guidelines website[including Guidelines International Network (GIN) , National Guideline Clearinghouse (NGC) , Registered Nurses Associationof Ontario (RNAO) , National Institute for Health and Care Excellence (NICE) , WHO guidelines network, Yimaitong website] ,professional academic website [including American College of Obstetricians and Gynecologists (ACOG) , Society of Obstetriciansand Gynaecologists of Canada (SOGC) , American Heart Association (AHA) , European Society of Cardiology (ESC) , Society ofObstetric Medicine of Australia and New Zealand (SOMANZ) website] , database (including JBI, Web of Science, Ovid, Embase,Cochrane Library, PubMed, CNKI, China Biomedical Literature Database, Wanfang Data, VIP) were searched by using computer.The search time was from January 2010 to February 2023. Two researchers independently evaluated the quality of the includedliterature, extracted and summarized the evidence. Results A total of 10 articles were included, including 4 guidelines, 1 expertconsensus, 1 clinical decision, 2 systematic evaluations, and 2 RCT. Among the 4 guidelines, 2 guidelines had a recommendationlevel of A, and 2 guidelines had a recommendation level of B. One expert consensus had a total quality score of > 5.0. One clinicaldecision was extracted from 2 cohort studies (both with a total quality score of 9.0) . Two systematic evaluations had a total qualityscore of ≥ 9.0. In the two RCTs, except item 8 of ADEL et al. 's study was "unclear" , the other items were "yes" ; in the studyof HOU Yanmei, except item 4 and item 5 were "unclear" , the other items were "yes" . Through the extraction and integration of evidence, the best evidence of lifestyle management in patients with pregnancy-induced hypertension including 21 items infour dimensions of management timing, diet management, exercise management and behavior management were finally formed.Conclusion This study summarizes the best evidence of lifestyle management in patients with pregnancy-induced hypertensionincluding 21 items in four dimensions of management timing, diet management, exercise management and behavior management,and provides reference for the development of personalized management programs for patients with pregnancy-inducedhypertension.

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