由于怀孕期间营养不良和叶酸缺乏,发展中国家的脊柱裂(SB)发病率高于美国。技术的进步使脊髓膜膨出(MM)的产前修复成为可能。
准则的目标是,(1)为最佳实践创建临床建议,在对现有文献进行系统回顾和分析的基础上,(2)获得相关组织对这些准则的多学科认可,(3)向医生传播教育内容,以改善MM婴儿的护理。
指南工作组开发了用于搜索PubMed和Embase的搜索词和策略,以查找1966年至2016年9月之间发表的文献。严格的纳入/排除标准用于筛选摘要并制定相关文章列表以进行全文审查。
指南作者旨在系统地回顾文献,并就出生后的关闭时间提出基于证据的建议。脑积水,产前关闭的影响,产前封闭对下床活动能力和脊髓栓系的影响。还评估了有关持续性脑室肥大和认知障碍的证据。为5个主题中的每一个确定并审查了数百个摘要。共有14项研究符合严格的纳入标准。
在全面系统回顾的基础上,共制定了5项临床实践建议,一级一级,2个二级和2个三级建议。完整的指南可以在https://www上找到。cns.org/guidelines/guidelines-spina-bifida-chapter-1。
The incidence of spina bifida (SB) in the developing world is higher than in the United States because of malnutrition and folic acid deficiency during pregnancy. Advances in technology have made prenatal repair of myelomeningocele (MM) possible.
The objective of the
guidelines are, (1) To create clinical recommendations for best practices, based on a systematic review and analysis of available literature, (2) to obtain multi-disciplinary endorsement of these
guidelines from relevant organizations, and (3) to disseminate the educational content to physicians to improve the care of infants with MM.
The
Guidelines Task Force developed search terms and strategies used to search PubMed and Embase for literature published between 1966 and September 2016. Strict inclusion/exclusion criteria were used to screen abstracts and to develop a list of relevant articles for full-text review.
Guidelines authors aimed to systematically review the literature and make evidence based recommendations about the timing of closure after birth, hydrocephalus, the impact of prenatal closure, and the effect of prenatal closure on ambulation ability and tethered spinal cord. Evidence concerning persistent ventriculomegaly and cognitive impairment was also evaluated. Hundreds of abstracts were identified and reviewed for each of the 5 topics. A total of 14 studies met stringent inclusion criteria.
Based on a comprehensive systematic review, a total of 5 clinical practice recommendations were developed, with 1 Level I, 2 Level II and 2 Level III recommendations.The full
guideline can be found at https://www.cns.org/
guidelines/
guidelines-spina-bifida-chapter-1.