摘要目的:遴选并提取剖宫产后再次妊娠产妇分娩方式决策的相关证据，并对最佳证据进行总结。方法:应用循证护理的方法，检索中国指南网、国际指南图书馆、英国国家临床医学研究所指南库、美国指南网、Joanna Briggs Institute循证卫生保健中心数据库、UpToDate、Cochrane Library、PubMed、中国知网、万方数据库、中国生物医学文献数据库、护理文献累积索引数据库、荷兰医学文摘数据库关于剖宫产后再次妊娠产妇分娩方式管理及决策的所有证据，包括指南、系统评价、证据总结、推荐实践、最佳临床实践信息册以及原始研究。检索时限为建库至2019年5月1日。由2名研究者对纳入文献进行质量评价，并提取证据。结果:共纳入证据13篇，包括指南6篇，专家共识1篇，系统评价6篇，共总结15条最佳证据，包括剖宫产术后再次妊娠阴道试产/选择性再次剖宫产人群、选择性再次剖宫产人群/子宫破裂影响因素、分娩方式管理、分娩决策工具4个方面。结论:建议临床应用证据时，应根据所在医疗机构的资源、医务人员应用证据的促进和阻碍因素、临床医生的合理判断、产妇提供的临床数据、产妇及家属意愿等进行证据选择。且由于最佳证据随时间推移不断更新，应用者还需持续更新证据，最终以科学的方法解决剖宫产后再次妊娠产妇分娩方式决策的问题，从而提升护理质量。

abstractsObjective:To select and extract the evidence of delivery mode decision making among repregnancy women with post cesarean section, and summarize the best evidence.Methods:Evidence-based nursing was used to retrieve the evidences on delivery mode decision making among repregnancy women with post cesarean section in the Chinese Guidelines Network, Guidelines International Network (GIN) , National Institute for Health and Clinical Excellence (NICE) , American GuidelineClearinghouse (NGC) , Joanna Briggs Institute Evidence-based Health Care Center of Australia, UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI) , WanFang data, Chinese Biological Medicine (CBM) and Cumulated Index to Nursing and Allied Health Literature (CINAHL) and Excerpta Medica Database (Embase) . The evidences included the guidelines, systematic reviews, evidence summaries, recommended practices, best clinical practice information booklets and primary studies.The retrieval time was from the establishment of the database to 1st May 2019.Results:A total of 13 evidences were included, six guideline, one expert consensus and six systematic reviews, which involved 15 best evidences in four aspects, trial of labor after cesarean section (TOLAC) /vaginal birth after cesarean (VBAC) population, VBAC/uterine rupture influencing factors, delivery mode management and the delivery decision making tools.Conclusions:Evidences of clinical practice should be recommended according to the resource of medical institutions, promotion and barrier factors when medical staff apply evidences, reasonable judgments of clinician, clinical data provided by delivery women, will of delivery women and their family members. Users should continuously update evidences since the best evidences update over time to solve the problems of delivery mode decision making among repregnancy women with post cesarean section by scientific method so as to improve the nursing quality.