慢性尿潴留患者间歇性导尿尿管选择和使用临床结局的系统评价  

Systematic review of the clinical outcome of intermittent urinary catheter selection and use in patients with chronic urinary retention

作　　者：周霞 张丽[1] 季学丽[1] 张杰[1] Zhou Xia;Zhang Li;Ji Xueli;Zhang Jie(Emergency Department,Jiangsu Provincial Hospital,Nanjing 210029,China)

机构地区：[1]江苏省人民医院急诊医学科,南京210029

出　　处：《中华现代护理杂志》2021年第7期902-907,共6页Chinese Journal of Modern Nursing

摘　　要：目的:对慢性尿潴留患者间歇性导尿尿管选择和使用进行系统评价,为今后临床实践中恰当应用导尿管提供有效证据。方法:检索Embase、PubMed、Health Technology Assessment Database、CINAHL、Web of Science、Cochrane Library、中国生物医学文献服务系统、CNKI、维普网、万方数据库中1990年1月1日—2020年4月30日收录的关于慢性尿潴留患者间歇性导尿尿管选择和使用的RCT研究,根据纳入标准和排除标准选取文献,提取资料并评价试验质量,采用RevMan 5.3软件进行Meta分析。结果:共13篇文献可纳入Meta分析。Meta分析显示,与单次使用无涂层导尿管组相比,预涂层导尿管组的尿路感染发生率较低[RR=0.60,95%CI(0.48,0.75),P<0.01],但在尿道损伤发生率方面差异无统计学意义[RR=1.19,95%CI(0.88,1.61),P=0.25];单次/重复使用间歇性导尿管的患者在尿路感染[RR=0.98,95%CI(0.70,1.39),P=0.93]和尿道损伤[RR=1.00,95%CI(0.21,4.79),P=1.00]方面差异无统计学意义。描述性分析结果提示,预涂层导尿管组的总体满意度高于单次使用非涂层导尿管组,但单次/重复使用间歇性导尿管患者之间总体满意度差异无统计学意义(P>0.05)。结论:在慢性尿潴留患者间歇性导尿实施过程中,使用预涂层间歇性导尿管或许能够降低患者尿路感染发生率,提高患者使用满意度,但尚无充足证据支持其改善尿道损伤方面的积极作用。此外,重复使用间歇性导尿管的安全性尚不能确定,后期仍需大量多中心大样本研究进一步验证此类结果。Objective To systematically review the selection and use of intermittent urinary catheter in patients with chronic urinary retention,and provide effective evidence for the proper use of catheters in clinical practice in the future.Methods Randomized controlled trials about the selection and use of intermittent urinary catheter in patients with chronic urinary retention published from January 1,1990 and April 30,2002 were retrieved from Embase,PubMed,Health Technology Assessment Database,CINAHL,Web of Science,Cochrane Library,SinoMed,CNKI,VIP,and Wanfang databases.The literature was selected according to the inclusion and exclusion criteria,the data was extracted and the trial quality was evaluated.RevMan 5.3 was used for Meta-analysis.Results A total of 13 articles could be included in Meta-analysis.Meta-analysis showed that the incidence of urinary tract infection in the pre-coated urinary catheter group was lower compared with the single-use uncoated catheter group[RR=0.60,95%CI(0.48,0.75),P<0.01],but there was no statistically significant difference in the incidence of urethral injury[RR=1.19,95%CI(0.88,1.61),P=0.25];there was no statistically significant difference in urethral injury[RR=0.98,95%CI(0.70,1.39),P=0.93]and urinary tract infection[RR=1.00,95%CI(0.21,4.79),P=1.00]between patients with single/repeated use of intermittent catheters.The descriptive analysis results indicated that the overall satisfaction of the pre-coated catheter group was higher than that of the single-use uncoated catheter group,but there was no statistically significant difference in overall satisfaction between patients with single/repeated use of intermittent catheters(P>0.05).Conclusions In the implementation of intermittent urinary catheterization in patients with chronic urinary retention,the use of pre-coated intermittent urinary catheters may reduce the incidence of urinary tract infection and improve patient satisfaction,but there is still insufficient evidence to support its role in ameliorating urethral injury.In additio

关 键 词：尿潴留 META分析 尿管 间歇性导尿 

分 类 号：R473.6[医药卫生—护理学]