氯己定尿道口消毒预防重症患者导尿管相关性尿路感染Meta分析  

Urethral Orifice Disinfection with Chlorhexidine in the Prevention of Catheter-Associated Urinary Tract Infection in Critically Ill Patients:A Meta-Analysis

作　　者：何立敏[1] 熊斌[2] HE Limin;XIONG Bin(The First Branch of the First Affiliated Hospital of Chongqing Medical University,Chongqing,China 400015;The Second Affiliated Hospital of Chongqing Medical University,Chongqing,China 400010)

机构地区：[1]重庆医科大学附属第一医院第一分院,重庆400015 [2]重庆医科大学附属第二医院,重庆400010

出　　处：《中国药业》2021年第19期105-109,共5页China Pharmaceuticals

基　　金：重庆市科卫联合医学科研项目[2020FYYX212]。

摘　　要：目的评估采用氯己定尿道口消毒预防重症患者导尿管相关性尿路感染(CAUTI)的效果。方法计算机检索PubMed,Web of Science,Embase,The Cochrane Library及中国知网、万方、维普等数据库中有关氯己定与CAUTI的文献,检索日期为自建库起至2021年2月28日。采用Cochrane系统评价手册Version 5.1.0质量评价标准评价文献质量,Revman 5.3软件对数据进行统计与分析。结果共纳入5项研究,共2334例患者,其中对照组1046例,氯己定尿道口消毒组1288例,均为随机对照试验。Meta分析结果显示,与对照组比较,氯己定尿道口消毒并不能显著降低CAUTI的发生率[RR=0.68,95%CI(0.33,1.40),P=0.29]及无症状性菌尿(ASB)的发生率[RR=0.62,95%CI(0.18,2.16),P=0.45]。结论氯己定尿道口消毒并未显著降低重症患者CAUTI和ASB的发生率。Objective To evaluate the efficacy of urethral orifice disinfection with chlorhexidine in the prevention of catheter-associated urinary tract infection(CAUTI)in critically ill patients.Methods The literature related to chlorhexidine and CAUTI in PubMed,Web of Science,Embase,The Cochrane Library,CNKI,WanFang and VIP databases were searched from the inception to February 28th,2021.The quality evaluation standard in the Cochrane Reviewens'Handbook(Version 5.1.0)was used to evaluate the quality of literature,and Revman 5.3 software was used for statistical analysis of the data.Results A total of five studies were included(a total of 2331 patients,1046 patients in the control group,and 1285 patients in the chlorhexidine urethral disinfection group),all of which were randomized controlled trials(RCTs).The Meta-analysis results showed that compared with those in the control group,urethral orifice disinfection with chlorhexidine did not significantly reduce the incidence of CAUTI[RR=0.68,95%CI(0.33,1.40),P=0.29]or the incidence of asymptomatic bacteriuria[RR=0.62,95%CI(0.18,2.16),P=0.45].Conclusion Urethral orifice disinfection with chlorhexidine does not significantly reduce the incidence of CAUTI or asymptomatic bacteriuria in critically ill patients.

关 键 词：氯己定 尿道口消毒 导尿管相关性尿路感染 效果 META分析 

分 类 号：R969.4[医药卫生—药理学] R983[医药卫生—药学]