Zhang Han, Jiang Jin-Xia, Xia Jie, Yu Chan, Zhong Min-Hui, Pang Qi-Ying, Mao Yan-Li, Duan Xia
Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Nursing Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
J Clin Nurs. 2023 May;32(9-10):2073-2085. doi: 10.1111/jocn.16288. Epub 2022 Mar 18.
Obstetric critical illness is an important factor that leads to an increase in maternal mortality. Early warning assessment can effectively reduce maternal and neonatal mortality and morbidity. However, there are multiple early warning systems, and the effect and applicability of each system in China still need to be explored.
To elaborate on the application, effectiveness and challenges of the existing early warning systems for high-risk obstetric women in China and to provide a reference for clinical practice.
A scoping review guided by the Arksey and O'Malley framework and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping review (PRISMA-ScR) guidelines.
We included original studies related to early warning and excluded those that were guidelines, consensus and reviews. The included studies were published in Chinese or English by Chinese scholars as of June 2021.
CNKI, Wanfang, VIP, Cochrane, CINAHL, Embase, PubMed and Web of Science databases were searched systematically, and the reference sections of the included papers were snowballed.
In total, 598 articles were identified. These articles were further refined using keyword searches and exclusion criteria, and 17 articles met the inclusion criteria. We extracted data related to each study's population, methods and results. Early warning tools, outcome indices, effects and challenges are discussed.
Although all studies have shown that early warning systems have good application effects, the use of early warning systems in China is still limited, with poor regional management and poor sensitivity for specific obstetric women. Future research needs to develop more targeted early warning tools for high-risk obstetric women and address the current challenges in clinical applications.
产科危重症是导致孕产妇死亡率上升的重要因素。早期预警评估可有效降低孕产妇和新生儿的死亡率及发病率。然而，现有多种早期预警系统，各系统在中国的效果及适用性仍有待探索。
阐述中国现有高危产科妇女早期预警系统的应用、效果及挑战，为临床实践提供参考。
一项以阿克西和奥马利框架为指导的范围综述，并按照系统评价和Meta分析的扩展综述报告规范（PRISMA-ScR）进行报告。
纳入与早期预警相关的原始研究，排除指南、共识和综述类研究。纳入的研究截至2021年6月由中国学者以中文或英文发表。
系统检索中国知网、万方、维普、考克兰、护理学与健康领域数据库、Embase、PubMed和科学引文索引数据库，并对纳入论文的参考文献进行滚雪球式检索。
共识别出598篇文章。通过关键词检索和排除标准对这些文章进一步筛选，17篇文章符合纳入标准。我们提取了与每项研究的人群、方法和结果相关的数据。对早期预警工具、结局指标、效果和挑战进行了讨论。
尽管所有研究均表明早期预警系统具有良好的应用效果，但早期预警系统在中国的使用仍有限，存在区域管理不佳以及对特定产科妇女敏感性较差的问题。未来研究需要为高危产科妇女开发更具针对性的早期预警工具，并应对当前临床应用中的挑战。
