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新生儿禁酒综合症:诊断和治疗的进展

Elisha M Wachman^1,2, Davida M Schiff³, Michael Silverstein^1,2

¹Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts.

|April 4, 2018

概括

新生儿戒断综合征 (NAS) 的诊断和治疗缺乏高质量的证据. 需要更多的临床试验来评估在子宫内接触阿片类药物的婴儿的诊断和治疗策略的结果.

科学领域:

新生儿护理
药理学
公共卫生

背景情况:

新生儿戒断综合征 (NAS) 由于子宫内阿片类药物暴露,每1000名美国新生儿中有6至20名.
在NAS诊断和管理方案中存在显著的差异.
目前对最佳NAS策略的证据有限.

研究的目的:

审查2007年至2017年间发表的有关NAS诊断和管理的重要研究.
总结关于药物治疗方法和非药物治疗方法的发现.
确定NAS护理的证据基础上的差距.

主要方法:

在PubMed,Web of Science和CINAHL的系统文献搜索 (2007年7月至2017年12月).
包括临床试验,队列研究和关于NAS诊断或管理的病例系列.
选摘要以确定相关的研究.

主要成果:

审查了53篇文章,包括9个RCT和35个队列研究,涉及超过11,905个母婴对照.
新的诊断方法是有前途的,
哺乳和住房等非药物干预措施很常见, 但缺乏高质量的试验支持.
药物干预是基于小型,异质的试验.
没有足够的证据将诊断或治疗方法与神经发育结果联系起来.

结论:

目前对NAS诊断和治疗的证据依赖于以中期结果为重点的小型低质量研究.
高质量的临床试验对于评估健康和神经发育结果至关重要.
需要进一步研究客观的诊断工具和有效的治疗方法.

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