表面麻醉剂辅助前列腺增生患者导尿效果的网状meta分析  

Reticular meta-analysis of urethral catheterization in patients with benign prostatic hyperplasia assisted by topical anesthetics

作　　者：罗玉红 李文娟[1] 张发 梁梦天 王超[2] 吴长富 周逢海 LUO Yuhong;LI Wenjuan;ZHANG Fa;LIANG Mengtian;WANG Chao;WU Changfu;ZHOU Fenghai(College of Nursing,Lanzhou University,Gansu Province,Lanzhou 730000,China;Department of Urology,Gansu Provincial People′s Hospital,Gansu Province,Lanzhou 730000,China)

机构地区：[1]兰州大学护理学院,甘肃兰州730000 [2]甘肃省人民医院泌尿外科,甘肃兰州730000

出　　处：《中国医药导报》2020年第31期30-34,共5页China Medical Herald

基　　金：甘肃省自然科学基金项目(17JR5RA333)。

摘　　要：目的系统评价不同表面麻醉剂用于前列腺增生患者导尿的效果。方法计算机检索PubMed、EMbase、Cochrane Library、Web of Science、CBM、CNKI、WanFang及VIP数据库相关随机对照试验(RCT),检索时限为建库至2019年11月。使用Cochrane Handbook 5.1.0进行文献质量评价,Stata 13.0和WinBUGS 1.4.3软件对文献中前列腺增生患者留置导尿的一次性置管成功率与置管疼痛发生率进行数据分析。结果共纳入33个RCTs,涉及5种表面麻醉剂,合计3329例样本量。网状meta分析结果显示:在一次性置管成功率方面,盐酸达克罗宁[OR=9.81,95%CI(2.36,52.59)]、盐酸丁卡因[OR=11.65,95%CI(5.05,31.00)]、舒泰[OR=0.07,95%CI(0.03,0.15)]、盐酸奥布卡因[OR=0.07,95%CI(0.03,0.17)]、利多卡因[OR=0.08,95%CI(0.05,0.15)]均优于无菌石蜡油,差异均有统计学意义(均P<0.05);在置管疼痛发生率方面,盐酸达克罗宁[OR=0.09,95%CI(0.01,0.66)]、盐酸丁卡因[OR=0.04,95%CI(0.01,0.25)]、舒泰[OR=7.13,95%CI(1.04,45.50)]、盐酸奥布卡因[OR=34.09,95%CI(7.18,210.45)]、利多卡因[OR=8.58,95%CI(2.96,24.69)]均优于无菌石蜡油,差异均有统计学意义(均P<0.05)。排序概率图结果提示,舒泰是提高一次性置管成功率的较优方案,盐酸奥布卡因是预防置管疼痛的较优方案。结论在提高一次性置管成功率方面,舒泰优于其他表面麻醉剂;在预防置管疼痛方面,盐酸奥布卡因优于其他表面麻醉剂。Objective To systematically evaluate the effect of different topical anesthetics on urethral catheterization in patients with benign prostatic hyperplasia.Methods Randomized controlled trials(RCT)related to PubMed,EMbase,Cochrane Library,Web of Science,CBM,CNKI,WanFang and VIP databases were searched by computer,and the retrieval time was set up until November 2019.Cochrane Handbook 5.1.0 was used to evaluate the literature quality,and Stata 13.0 and WinBUGS 1.4.3 software were used to analyze the one-time catheterization success rate and the incidence of catheterization pain in patients with benign prostatic hyperplasia in the literature.Results A total of 33 RCTs involving 5 topical anesthetics were included,with a total sample size of 3329 cases.The results of reticular meta-analysis showed that:In terms of one-time catheterization success rate,Dyclonine Hydrochloride(OR=9.81,95%CI[2.36,52.59]),Tetracaine Hydrochloride(OR=11.65,95%CI[5.05,31.00]),Shutai(OR=0.07,95%CI[0.03,0.15]),Benoxinate Hydrochloride(OR=0.07,95%CI[0.03,0.17]),Lidocaine(OR=0.08,95%CI[0.05,0.15])were superior to sterile paraffin oil,the differences were statistically significant(all P<0.05).In terms of the incidence of catheterization pain,Dyclonine Hydrochloride(OR=0.09,95%CI[0.01,0.66]),Tetracaine Hydrochloride(OR=0.04,95%CI[0.01,0.25]),Shutai(OR=7.13,95%CI[1.04,45.50]),Benoxinate Hydrochloride(OR=34.09,95%CI[7.18,210.45])and Lidocaine(OR=8.58,95%CI[2.96,24.69])were all superior to sterile paraffin oil,the differences were statistically significant(all P<0.05).The result of the ranking probability graph indicated that Shutai was the best solution to increase the one-time catheterization success rate,and Benoxinate Hydrochloride was the best solution to prevent catheterization pain.Conclusion In improving the one-time catheterization success rate,Shutai is superior to other topical anesthetics.Benoxinate Hydrochloride is superior to other topical anesthetics in the prevention of catheterization pain.

关 键 词：导尿 前列腺增生症 表面麻醉剂 疼痛程度 网状meta分析 

分 类 号：R697[医药卫生—泌尿科学]