The aim of this review was to investigate whether manual rotation can be used to reduce vacuum, forceps and caesarean deliveries in women with occiput posterior or occiput transverse positions from 7 cm dilation in la...The aim of this review was to investigate whether manual rotation can be used to reduce vacuum, forceps and caesarean deliveries in women with occiput posterior or occiput transverse positions from 7 cm dilation in labour. A search strategy was developed and relevant papers published between 1946 and January 2015 were identified from electronic databases. Key search terms used were manual and digital rotation, labour presentation, obstetric labour complications, occiput posterior and version foetal. The search revealed 330 papers. A short list of 33 publications of possible relevance was compiled and assessed using the following criteria: primary studies on the effectiveness of manual rotation performed in women with singleton occiput posterior or occiput transverse presentations published in English or the Scandinavian languages. The quality of the included studies was evaluated by means of the critical appraisal tools for quantitative studies. Seven studies were included in the thematic analysis. The results varied but the main finding was that in order to decrease vacuum, forceps and caesarean deliveries by means of manual rotation, it is essential that the procedure is successful. The success rate of manual rotation is dependent on the experience of the healthcare professionals who perform the rotation procedure rather than the technique employed. Predictors of successful manual rotation were used after engagement of the foetal head, at full dilatation and prophylactic use before failure to progress in labour. In conclusion, although the results vary, there is a consensus in all the studies that manual rotation is worth considering and that it can contribute to decreasing vacuum, forceps and caesarean deliveries. The implications for practice are that successful manual rotation can reduce caesarean delivery and increase spontaneous vaginal delivery, but experience is necessary to perform successful rotations. Because there are no risk factors associated with manual or digital rotation when performed after engagement of the head and at full dilatation, they are worth considering. The central role of the midwife in each individual labour makes her important for ensuring that manual rotation can be considered at the right time in labour.展开更多
目的对乳腺癌术后并发腋网综合征患者物理康复干预研究进行范围综述,明确干预要素及应用现状,为进一步制订物理康复干预策略提供参考。方法按照范围综述指南,系统检索PubMed、CINAHL、Embase、Cochrane Library、Web of Science、中国...目的对乳腺癌术后并发腋网综合征患者物理康复干预研究进行范围综述,明确干预要素及应用现状,为进一步制订物理康复干预策略提供参考。方法按照范围综述指南,系统检索PubMed、CINAHL、Embase、Cochrane Library、Web of Science、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库中有关乳腺癌术后并发腋网综合征患者物理康复的干预研究,检索时限为建库至2024年4月。由2名研究者对纳入文献进行数据提取及分析。结果共纳入16篇文献,主要由康复治疗师和护士对乳腺癌术后并发腋网综合征患者以手法治疗、运动疗法和物理因子多项联合方式进行物理康复干预;干预频率、时长因不同的干预形式存在较大差异,干预最多的是运动疗法,如拉伸运动和患肢功能锻炼等,干预频率每天3~5次,每次10~20 min,持续2~4周;干预对乳腺癌并发腋网综合征患者的患肢功能、临床症状、生活质量指标等有不同程度的积极影响。结论乳腺癌术后并发腋网综合征患者的物理康复干预研究尚处于发展阶段,其积极影响已得到初步验证。未来护士可以作为物理康复干预的主体,发挥多学科团队作用、利用远程监督和支持系统,开展高质量、多中心的随机对照试验,明确更有效的干预策略,以便为患者制订个性化、科学化的物理康复干预方案。展开更多
文摘The aim of this review was to investigate whether manual rotation can be used to reduce vacuum, forceps and caesarean deliveries in women with occiput posterior or occiput transverse positions from 7 cm dilation in labour. A search strategy was developed and relevant papers published between 1946 and January 2015 were identified from electronic databases. Key search terms used were manual and digital rotation, labour presentation, obstetric labour complications, occiput posterior and version foetal. The search revealed 330 papers. A short list of 33 publications of possible relevance was compiled and assessed using the following criteria: primary studies on the effectiveness of manual rotation performed in women with singleton occiput posterior or occiput transverse presentations published in English or the Scandinavian languages. The quality of the included studies was evaluated by means of the critical appraisal tools for quantitative studies. Seven studies were included in the thematic analysis. The results varied but the main finding was that in order to decrease vacuum, forceps and caesarean deliveries by means of manual rotation, it is essential that the procedure is successful. The success rate of manual rotation is dependent on the experience of the healthcare professionals who perform the rotation procedure rather than the technique employed. Predictors of successful manual rotation were used after engagement of the foetal head, at full dilatation and prophylactic use before failure to progress in labour. In conclusion, although the results vary, there is a consensus in all the studies that manual rotation is worth considering and that it can contribute to decreasing vacuum, forceps and caesarean deliveries. The implications for practice are that successful manual rotation can reduce caesarean delivery and increase spontaneous vaginal delivery, but experience is necessary to perform successful rotations. Because there are no risk factors associated with manual or digital rotation when performed after engagement of the head and at full dilatation, they are worth considering. The central role of the midwife in each individual labour makes her important for ensuring that manual rotation can be considered at the right time in labour.
文摘目的对乳腺癌术后并发腋网综合征患者物理康复干预研究进行范围综述,明确干预要素及应用现状,为进一步制订物理康复干预策略提供参考。方法按照范围综述指南,系统检索PubMed、CINAHL、Embase、Cochrane Library、Web of Science、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库中有关乳腺癌术后并发腋网综合征患者物理康复的干预研究,检索时限为建库至2024年4月。由2名研究者对纳入文献进行数据提取及分析。结果共纳入16篇文献,主要由康复治疗师和护士对乳腺癌术后并发腋网综合征患者以手法治疗、运动疗法和物理因子多项联合方式进行物理康复干预;干预频率、时长因不同的干预形式存在较大差异,干预最多的是运动疗法,如拉伸运动和患肢功能锻炼等,干预频率每天3~5次,每次10~20 min,持续2~4周;干预对乳腺癌并发腋网综合征患者的患肢功能、临床症状、生活质量指标等有不同程度的积极影响。结论乳腺癌术后并发腋网综合征患者的物理康复干预研究尚处于发展阶段,其积极影响已得到初步验证。未来护士可以作为物理康复干预的主体,发挥多学科团队作用、利用远程监督和支持系统,开展高质量、多中心的随机对照试验,明确更有效的干预策略,以便为患者制订个性化、科学化的物理康复干预方案。
