留置导尿管拔管前夹闭尿管的必要性探讨  

Research on necessity of clamping catheter for patients with indwelling urinary catheter before removal

作　　者：张会[1] 王翠丽[2] ZHANG Hui;WANG Cuili(Jining NO.1 People's Hospital,Shandong 272000 China)

机构地区：[1]济宁市第一人民医院 [2]山东大学护理学院

出　　处：《循证护理》2019年第1期19-23,共5页Chinese Evidence-Based Nursing

摘　　要：[目的]对留置导尿管病人拔管前夹闭导尿管的必要性进行文献循证,为临床实践提供依据。[方法]检索2007年—2017年发表的中英文文献,研究类型限定为随机对照实验(RCT)或准随机对照实验(quasi-RCT)。对纳入文献按导管留置时间及夹管程序进行分类效果分析及方法学评价。[结果]共纳入12篇文献,包括9篇RCT和3篇quasi-RCT。夹闭程序可分为充盈式拔管和训练式拔管。充盈式拔管临床效果无一致结论,短期置管病人训练式拔管引发的并发症更多。纳入的多数文献方法学设计存在缺陷,需更多设计严谨的研究来验证拔管前夹闭导管的必要性。[结论]现有证据表明,短期置管病人拔管前不必要常规实施训练式拔管。充盈式拔管及长期置管病人训练式拔管的必要性尚需进一步研究。Objective:To evaluate the necessity of clamping catheter prior to removal in patients with indwelling urinary catheters(IUC)so as to provide an evidence basis for clinical practice.Methods:The literature published in Chinese and English journals between 2007 and 2017 were searched.The study methodology was limited to randomized controlled trial (RCT) or quasi-randomized controlled trial (quasi-RCT).According to the catheterization duration of IUC and the clamping procedure,the findings of the included studies were analyzed,together with evaluating their methodological quality.Results:A total of 12 studies were included in this literature review,consisting of nine RCTs and three quasi-RCTs.The clamping procedure can be divided into filling removal and training removal.There was no consensus about the clinical effectiveness of filling removal.More complications were reported when training removal was implemented among patients with short-term IUC.The methodological design of the majority of the included studies was problematic.More rigorous research is needed to verify the necessity of clamping catheter before removing IUC.Conclusions: It is not necessary to routinely implement training removal for patients with short-term IUC.Further study is needed to evaluate the necessity of filling removal and training removal for patients with long-term IUC.

关 键 词：留置导尿管 拔管 夹闭 膀胱功能 综述 进展 

分 类 号：R472[医药卫生—护理学]