留置导尿对关节置换术后病人泌尿系统并发症影响的Meta分析  

Effect of indwelling catheter on urinary complications of patients after total joint arthroplasty:a systematic evaluation

作　　者：张岚[1] 纪荣建 王仁秀 刘敏[4] 杜宁 许翠萍 ZHANG Lan;JI Rongjian;WANG Renxiu;LIU Min;DU Ning;XU Cuiping(School of Nursing and Rehabilitation,Shandong University,Shandong 250012 China)

机构地区：[1]山东大学护理与康复学院,山东250012 [2]山东大学 [3]山东中医药大学 [4]山东第一医科大学 [5]山东大学附属千佛山医院

出　　处：《护理研究》2021年第14期2489-2496,共8页Chinese Nursing Research

摘　　要：目的:系统评价留置导尿对关节置换术(TJA)术后病人泌尿系统并发症的影响。方法:计算机检索Web of Science、PubMed、The Cochrane Library、EMbase、中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang Data)和维普数据库(VIP)中有关留置导尿应用于TJA术后病人的随机对照试验。检索时限为建库至2020年6月17日。2名研究员独立完成文献筛选、数据提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果:共纳入12篇文献,涉及2063例病人。Meta分析结果显示,与间断导尿相比,留置导尿降低了病人术后尿潴留发生率[RR=0.39,95%CI(0.30,0.51),P<0.00001],但增加了尿路感染发生率[RR=1.66,95%CI(1.11,2.47),P=0.01]和尿路刺激征发生率[RR=6.69,95%CI(2.22,20.15),P=0.0007]。结论:现有证据表明,留置导尿可以减少TJA病人术后尿潴留发生率,但会增加其尿路感染和尿路刺激征发生率。因纳入研究较少且缺乏相关数据,未来可就麻醉方式、手术部位、留置时间等开展多中心、大样本研究以进一步评估留置导尿对病人膀胱功能的影响。Objective:To systematically evaluate the effect of indwelling catheter on urinary complications of patients after total joint arthroplasty(TJA).Methods:Randomized controlled trials on application of indwelling catheter in patients after TJA,were retrieved from Web of Science,PubMed,The Cochrane Library,EMbase,CNKI,Wanfang Data and VIP.The retrieval period was from the establishment of databases to 17 June,2020.After two researchers independently completed literature screening,data extraction and quality evaluation,RevMan 5.3 software was used for Meta analysis.Results:A total of 12 articles with 2063 patients were included.Meta analysis results showed that compared with intermittent catheterization,indwelling catheter reduced incidence of postoperative urinary retention[RR=0.39,95%CI(0.30,0.51),P<0.00001],but increased incidence of urinary tract infection[RR=1.66,95%CI(1.11,2.47),P=0.01]and incidence of urinary tract irritation[RR=6.69,95%CI(2.22,20.15),P=0.0007].Conclusions:Existing evidence shows that indwelling catheter can reduce incidence of postoperative urinary retention of patients with TJA,while it will increase incidence of urinary tract infection and incidence of urinary tract irritation.This paper discussed less studies and was lack of relevant data.And multi⁃center and large⁃sample studies can be carried out in the future on anesthesia methods,surgical sites,indwelling time and others to further evaluate the effect of indwelling catheter on patients'bladder function.

关 键 词：关节置换 留置导尿 尿潴留 尿路感染 尿路刺激征 循证护理 系统评价 

分 类 号：R473.6[医药卫生—护理学]