剖宫产术后使用镇痛泵导尿管留置时间对尿潴留发生影响的Meta分析  

The different timing of removing indwelling urinary catheter for puerperas who use patient controlled analgesia after cesarean section：a meta- analysis

作　　者：李英杰[1] 廖容[1] 吴显兰 

机构地区：[1]重庆医科大学附属永川医院教务科,402160

出　　处：《中国实用护理杂志》2017年第33期2636-2640,共5页Chinese Journal of Practical Nursing

摘　　要：目的 探讨不同时间拔除留置尿管对剖宫产术后使用镇痛泵的产妇尿潴留发生的影响.方法 检索PubMed、EMbase、Cochrane Library、Medline、中国知网（CNKI）、中国生物医学文献库（CBM）、维普中文期刊全文数据库（VIP）、万方数据库至2016年12月,收集24h、36h、48h拔除导尿管对剖宫产术后使用镇痛泵产妇尿潴留发生率的随机对照研究成果,进行文献质量评价后,用RevMan5.3软件进行统计分析.结果 共纳入10篇文献,共计1639名产妇.留置24h拔出尿管后尿潴留发生率比留置36h高,差异具有统计学意义（RR=4.95,95% CI为3.67~6.68,P〈0.01）;留置36h拔出尿管后尿潴留发生率比留置48h高,差异具有统计学意义（RR=3.00,95% CI为1.66~5.41,P〈0.01）;留置24h拔出尿管后尿潴留发生率比留置48h高,差异具有统计学意义（RR=11.84,95% CI为7.84~18.66,P〈0.01）.结论 为防止尿潴留发生,剖宫产术后使用自控镇痛泵尿管拔管最佳时间以48h为宜.Objective To assess the effects of removing indwelling urinary catheter at different timing on urinary retention puerper as who use patient controlled analgesia（PCA）after cesarean section. Methods Taking the database of PubMed,Embase,Cochrane Library,Medline,CNKI,CBM,VIP and Wanfang before December 2016 as the retrieval sources; collecting the Results of randomized controlled trial（RCT） about the incidence of postpartum urinary retention with PCA which removing the ureteral catheter after 24 hours, 36 hours, and 48 hours respectively; using RevMan 5.3 software for statistical analysis. Results A total of 10 study papers were collected, included involving 1 639 maternity patients.The incidence of urinary retention with ureteral catheter removal after 24 hours was higher than after 36 hours, the difference was statistically significant （RR=4.95, 95% CI 3.67-6.68, P〈0.01）; the incidence of urinary retention with ureteral catheter removal after 36 hours was higher than after 48 hours, the difference was statistically significant（RR=3.00,95% CI 1.66-5.41,P〈0.01）;the incidence of urinary retention with ureteral catheter removal after 24 hours was higher than after 48 hours the difference was statistically significant （RR=11.84, 95% CI 7.84-18.66, P〈0.01）. Conclusion In order to prevent the occurrence of urinary retention,the more appropriate timing to remove the urinary catheter after cesarean section with PCA is after 48 hours.

关 键 词：剖宫产术 镇痛泵 留置尿管 尿潴留 META分析 

分 类 号：R473.71[医药卫生—护理学]