以质量求发展,以服务铸品牌

护理学报 ›› 2023, Vol. 30 ›› Issue (13): 47-52.doi: 10.16460/j.issn1008-9969.2023.13.047

• 循证护理 • 上一篇    下一篇

妊娠期妇女不宁腿综合征管理的最佳证据总结

庄云婷1, 王志坚2, 李娟华3, 肖燕璇1, 刘益君1   

  1. 1.南方医科大学护理学院,广东 广州 510515;
    2.南方医科大学南方医院 产科,广东 广州 510515;
    3.南方医科大学南方医院增城分院 产科,广东 广州 511300
  • 收稿日期:2023-02-12 出版日期:2023-07-10 发布日期:2023-08-04
  • 通讯作者: 王志坚(1970-),男,辽宁锦州人,教授,主任医师,博士研究生导师。E-mail: wzjnfyy@163.com
  • 作者简介:庄云婷(2000-),女,陕西西安人,本科学历,硕士研究生在读。
  • 基金资助:
    国家自然科学基金(81971415); 南方医科大学南方医院院长基金项目(2021H006); 南方医科大学2022年大学生创新创业训练项目(202212121302)

Best evidence summary for management of restless leg syndrome during pregnancy

ZHUANG Yun-ting1, WANG Zhi-jian2, LI Juan-hua3, XIAO Yan-xuan1, LIU Yi-jun1   

  1. 1. School of Nursing, Southern Medical University, Guangzhou 510515, China;
    2. Dept. of Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
    3. Dept. of Obstetrics, Zencheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511300, China
  • Received:2023-02-12 Online:2023-07-10 Published:2023-08-04

摘要: 目的 遴选并总结妊娠期妇女不宁腿综合征管理的最佳相关证据,为医护人员临床实践管理提供依据。方法 计算机系统检索BMJ、Cochrane Library、JBI、UpToDate、Embase、Clinical Trial、Web of Science、PubMed、中国知网、维普、万方数据库、CBM、中国指南网、GIN、SIGN、NGC、ACOG、SOGC中有关妊娠期孕妇不宁腿综合征管理措施的循证文献,筛选出符合纳入标准的文献,由2名研究员独立评价文献质量并汇总证据。结果 共纳入13篇文献,包括指南3篇、临床决策5篇、系统评价4篇及证据总结1篇,提取出25条有关妊娠期不宁腿综合征管理的最佳证据,包括评估与诊断、总体管理原则、避免诱发因素、健康教育、运动锻炼、手法设备措施和药物治疗7个方面。结论 本研究从评估与诊断、总体管理原则、避免诱发因素、健康教育、运动锻炼、手法设备措施和药物治疗这7个方面归纳分析有关妊娠期不宁腿综合征管理的最佳证据,医护人员可根据临床实际选择并应用本研究整合25条证据,以降低孕妇不宁腿综合征发生率并提高孕期生活质量。

关键词: 不宁腿综合征, 妊娠, 睡眠障碍, 管理, 循证护理

Abstract: Objective To select and summarize the best evidence for management of restless leg syndrome (RLS) during pregnancy, so as to provide evidence for clinical practice. Methods We conducted systematical research with computer in databases of BMJ, Cochrane Library, JBI, UpToDate, Embase, Clinical Trial, Web of Science, PubMed, CNKI, VIP, Wanfang Database, CBM, Medical Pulse, GIN, SIGN, NGC, ACOG and SOGC for all the evidence regarding management of RLS during pregnancy. Literature was evaluated and summarized by 2 researchers independently. Results Thirteen articles were enrolled, including 3 guidelines, 5 clinical decisions, 4 systematic reviews and 1 evidence summary. A total of 25 pieces of evidence were summarized, including assessment and diagnosis, general management principles, avoiding precipitating factors, health education, exercises, manual/equipment therapy and medication. Conclusion The best evidence is summarized into 7 aspects of assessment and diagnosis, general management principles, avoiding precipitating factors, health education, exercises, manual/equipment therapy and medication for the management of RLS during pregnancy. It is recommended that the 25 pieces of evidence be used into clinical practice to reduce the incidence of RLS and improve the quality of life during pregnancy.

Key words: restless leg syndrome, pregnancy, sleep disorder, management, evidence-based nursing

中图分类号: 

  • R473.71
[1] Mendes A, Silva P.Possible etiologies of restless legs syndrome in pregnancy:a narrative review[J].Sleep science (Sao Paulo, Brazil),2022,15(4):471-479.DOI:10.5935/1984-0063.20220080.
[2] Chen SJ, Shi L, Bao YP, et al.Prevalence of restless legs syndrome during pregnancy: a systematic review and Meta-analysis[J]. Sleep Med Rev,2018,40:43-54. DOI:10.1016/j.smrv.2017.10.003.
[3] Grover A, Bilodeau C, Ambrosio D.Restless leg syndrome in pregnancy[J]. Obstet Med,2015,8(3):121-125. DOI:10.1177/1753495X15587452.
[4] Tuna O, Yuksel E, Ruzgar S.Prevalence of restless leg syndrome and effects on quality of life during pregnancy[J]. Sleep Breath,2021,25(4):2127-2134. DOI:10.1007/s11325-021-02311-5.
[5] 白丽娟,吴建杰,张玉涛,等.妊娠期睡眠生理及睡眠障碍的研究进展[J].中国全科医学,2020,23(8):1008-1016. DOI: 10.12114/j.issn.1007-9572.2019.00.139.
[6] Facco L, Chan J, Patel S.Common sleep disorders in pregnancy[J]. Obstet and gynecology,2022,140(2):321-339.DOI: 10.1097/AOG.0000000000004866.
[7] Steinweg K, Nippita T, Cistulli PA,et al.Maternal and neonatal outcomes associated with restless legs syndrome in pregnancy: a systematic review[J].Sleep Med Rev,2020,54:103-159. DOI:10.1016/j.smrv.2020.101359.
[8] Akbaş P, Sözbir SY. Restless legs syndrome and quality of life in pregnant women[J]. Rev Assoc Med Bras, 2019,65(5):618-624. DOI:10.1590/1806-9282.65.5.618.
[9] Sawatari H, Yoshimura C, Amagase H, et al.Relationship between restless legs syndrome associated symptoms and presence of depression during pregnancy[J]. Women health, 2022,62(3):265-271. DOI:10.1080/03630242.2022.2055698.
[10] 胡雁,郝玉芳.循证护理学[M].2版.北京:人民卫生出版社, 2018.
[11] Shaneyfelt T.Pyramids are guides not rules: the evolution of the evidence pyramid[J]. Evid Based Med, 2016,21(4):121-122. DOI:10.1136/ebmed-2016-110498.
[12] AGREE Proiect Office. The AGREEⅡinstrument[EB/OL].[2023-02-01].http://www.agreetrust.org.
[13] Pieper D, Koensgen N, Breuing J, et al.How is AMSTAR applied by authors-a call for better reporting[J]. BMC Med Res Methodol,2018,18(1):56.DOI:10.1186/s12874-018-0520-z.
[14] Foster M, Shurtz S.Making the critical appraisal for summaries of evidence (CASE) for evidence-based medicine (EBM):critical appraisal of summaries of evidence[J].J Med Libr Assoc, 2013,101(3):192-198.DOI:10.3163/1536-5050.101.3.008.
[15] 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.DOI:10.16821/j.cnki.hsjx.2015.11.002.
[16] Picchietti DL, Hensley JG, Bainbridge JL, et al.Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation[J].Sleep Med Rev,2015,22:64-77. DOI:10.1016/j.smrv.2014.10.009.
[17] 中国医师协会神经内科医师分会睡眠学组,中华医学会神经病学分会睡眠障碍学组,中国睡眠研究会睡眠障碍专业委员会.中国不宁腿综合征的诊断与治疗指南(2021版)[J].中华医学杂志,2021,101(13):908-925.DOI:10.3760/cma.j.cn112137-20200820-02431.
[18] Mottola MF, Davenport MH, Ruchat SM, et al.2019 Canadian guideline for physical activity throughout pregnancy[J]. Br J Sports Med, 2018, 52(21):1339-1346.DOI:10.1136/bjsports-2018-100056.
[19] Naguy A, Alamiri B.Gestational restless leg syndrome: in the spotlight[J]. Prim Care Companion CNS Disord,2023,25(1):32-35. DOI:10.4088/PCC.22br03235.
[20] Picchietti D. Restless legs syndrome during pregnancy and lactation[EB/OL].(2023-01-17)[2023-02-01]. https://www.uptodate.cn/contents/zh-Hans/restless-legs-syndrome-during-pregnancy-and-lactation.
[21] Jahani M, Kolla BP. Moore KM, et al.Management of restless legs syndrome in pregnancy and lactation[J]. J Prim Care Community Health,2020,11:2150132720905950. DOI: 10.1177/2150132720905950.
[22] Garbazza C, Manconi M.Management strategies for restless legs syndrome/Willis-Ekbom disease during pregnancy[J]. Sleep Med Clin,2018,13(3):335-348. DOI:10.1016/j.jsmc.2018.05.001.
[23] Gupta R, Dhyani M, Kendzerska T, et al.Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment[J]. Acta Neurol Scand,2016,133(5):320-329. DOI:10.1111/ane.12520.
[24] Huang C, Tang JF, Sun W, et al.Effectiveness of acupuncture in the management of restless leg systematic review and Meta-analysis[J]. Ann Palliat Med,2021,10(10):495-505. DOI:10.21037/apm-21-2309.
[25] Trotti L, Becker A. Iron for the treatment of restless legs syndrome[J]. Cochrane Database Syst Rev, 2019, 1(1):CD007834.
[26] Harrison E, Keating J, Morgan P.Non-pharmacological interventions for restless legs syndrome: a systematic review of randomised controlled trials[J]. Disabil Rehabil,2019,41(17):2006-2014. DOI:10.1080/09638288.2018.1453875.
[27] Xu XM, Liu Y, Jia SY, et al.Complementary and alternative therapies for restless legs syndrome: an evidence-based systematic review[J]. Sleep Med Rev,2018,38:158-167. DOI:10.1016/j.smrv.2017.06.003.
[28] Guay A, Houle M, O'Shaughnessy J, et al. Current evidence on diagnostic criteria, relevant outcome measures, and efficacy of nonpharmacologic therapy in the management of restless legs syndrome (RLS): a scoping review[J]. J Manipulative Physiol Ther,2020,43(9):930-941. DOI:10.1016/j.jmpt.2020.05.004.
[29] Laleli B, Elmas B, Tugrul D, et al.Evaluation of serum selenium level, quality of sleep, and life in pregnant women with restless legs syndrome[J]. Biol Trace Elem Res,2023,201(3):1143-1150. DOI:10.1007/s12011-022-03447-5.
[30] Sato M, Matsui K, Sasai T, et al.The prevalence and associated factors of seasonal exacerbation of subjective symptoms in Japanese patients with restless legs syndrome[J]. Sleep Med, 2023, 101:238-243. DOI:10.1016/j.sleep.2022.11.017.
[31] Terzi H, Terzi R, Zeybek B, et al.Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy[J]. Sleep Breath, 2015, 19(1):73-78. DOI:10.1007/s11325-014-0964-2.
[32] Rahmani N, Araj-Khodaei M, Mohammad S,et al.The effect of cognitive-behavioral counseling with or without citrus aurantium essential oil on sleep quality in pregnant women:a randomized controlled trial[J].Sleep Biol Rhythms,2023,5:1-10. DOI:10.1007/s41105-023-00451-7.
[33] 徐思英,黄莹,刘丽华,等.基于互联网认知行为疗法对产妇负性情绪干预效果的Meta分析[J].护理学报,2021,28(4):36-42.DOI:10.16460/j.issn1008-9969.2021.04.036.
[34] Sönmez A, Aksoy Y.Effects of sleep hygiene training given to pregnant women with restless leg syndrome on their sleep quality[J]. Sleep Breath,2018,22(2):527-535. DOI: 10.1007/s11325-018-1619-5.
[35] Lin S, Zhang H, Gao T, et al.The association between obesity and restless legs syndrome: a systemic review and Meta-analysis of observational studies[J]. J Affect Disord, 2018, 235:384-391. DOI:10.1016/j.jad.2018.04.042.
[36] 谢果红,郑赞,吕媛,等.孕前体质量指数与后代先天性心脏病关联剂量反应关系的Meta分析[J].护理学报,2018,25(15):30-36. DOI:10.16460/j.issn1008-9969.2018.15.030.
[37] Thirugnanam S.Effect of aerobic exercise and yogasana program on peripheral neuropathy patients with restless leg syndrome[J]. Sleep Medicine,2019, 64:382-383.DOI:10.1016/j.sleep.2019.11.1067.
[38] Jafarimanesh H, Vakilian K, Mobasseri S.Thermo-therapy and cryotherapy to decrease the symptoms of restless leg syndrome during the pregnancy: a randomized clinical trial[J]. Complement Ther Med,2020,50:102409. DOI:10.1016/j.ctim.2020.102409.
[39] Gossard TR, Trotti LM, Videnovic A, et al.Restless legs syndrome: contemporary diagnosis and treatment[J]. Neurotherapeutics,2021,18(1):140-155. DOI:10.1007/s13311-021-01019-4.
[40] 李明先. 穴位按压联合早期体位干预对无剖宫产指征孕妇分娩结局的影响[J].护理学报,2016,23(2):65-67. DOI: 10.16460/j.issn1008-9969.2016.02.065.
[41] Bartl M, Trenk C, Muntean ML, et al.Intravenous iron supplementation therapy Restless-Legs-Syndrome[J]. Nervenarzt, 2021,92(10):1067.DOI:10.1007/s00115-021-01096-y.
[42] World Health Organization.Guideline: daily iron and folic acid supplementation in pregnant women[M].Geneva: World Health Organization, 2012.
[43] Trenk C, Winkelmann J, Oertel W, et al.Ferric carboxymaltose in patients with restless legs syndrome and nonanemic iron deficiency: a randomized trial[J]. Mov Disorder,2017,32(10):1478-1482. DOI:10.1002/mds.27040.
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