早期拔除尿管对中老年经尿道前列腺电切术后患者泌尿系统并发症影响的Meta分析  

The influence of early removal of urinary catheters on urinary complications in middle-aged and elderly patients after transurethral resection of the prostate:a meta-analysis

作　　者：王海播 李文娟 张文平 田翠杰 张静 程剑剑 Wang Haibo;Li Wenjuan;Zhang Wenping;Tian Cuijie;Zhang Jing;Cheng Jianjian(Department of Respiratory Intensive Care,Henan Provincial People's Hospital/People's Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院(郑州大学人民医院)呼吸重症病区,郑州450003

出　　处：《中华老年医学杂志》2022年第4期478-482,共5页Chinese Journal of Geriatrics

摘　　要：目的系统评价尿管拔除时间对中老年经尿道前列腺电切术后患者泌尿系统并发症的影响.方法检索PubMed、Embase、Cochrane Library、Web of Science、万方、维普中文期刊数据库、中国知网、中国生物医学文献数据库中有关经尿道前列腺电切术后尿管拔除时间的随机对照试验或临床对照试验,采用RevMan5.3软件对数据进行统计分析.结果共纳入9项随机对照研究,1项临床对照试验,共1529例患者.Meta分析结果显示术后≤3 d拔除尿管和术后4~7 d拔除尿管相比,在尿路感染方面,两者差异具有统计学意义[OR=0.34,95%CI(0.20~0.58),P<0.01],但在继发性出血方面,两者差异无统计学意义[OR=0.86,95%CI(0.44~1.66)P>0.05].术后≤24 h与术后2~3 d拔除尿管的重新留置尿管发生率、继发性出血发生率比较,差异无统计学意义[OR=1.32,95%CI(0.57~3.06),P>0.05;OR=3.18,95%CI(0.32~31.56),P>0.05].结论术后早期(≤3 d)拔除尿管对降低尿路感染发生率有明显优势;术后24 h内拔除尿管相比于24 h后并不会增加重新置管、继发性出血的发生率.Objective To systematically analyze the influence of early removal of urinary catheters on urinary complications in middle-aged and elderly patients after transurethral resection of the prostate.Methods Randomized controlled trials or clinical controlled trials on early removal of urinary catheters in patients after transurethral resection of the prostate were retrieved from PubMed.Embase,the Cochrane Library,the Web of Science,CNKI,Wanfang Data,VIP database and CBM.RevMan 5.3 was used to analyzed the data.Results Nine randomized controlled trials and one controlled clinical trial involving a total of 1529 patients were included.The results of meta-analysis showed that there was a significant difference between catheter removal within three days after surgery and removal 4-7days after surgery in the incidence of urinary tract infections[OR=0.34.95%CI(0.20-0.58).P<0.01].but there was no significant difference in secondary hemorrhage[OR=0.86.95%CI(0.44-1.66).P>0,05].There was no significant difference in the incidence of re-catheterization or secondary hemorrhage between 24 hours and 2-3 days after surgery[OR=1.32,95%CI(0.57-3.06),P>0.05OR=3.18,95%CI(0.32-31.56).P>0.05].Conelusions Early postoperative catheter removal(within 3 days)has a clear advantage in reducing the incidence of urinary tract infections,and urinary catheter removal within 24 hours does not increase the incidence of re-catheterization or secondary hemorrhage compared with removal after 24 hours.

关 键 词：前列腺增生 经尿道前列腺切除术 泌尿道感染 

分 类 号：R699[医药卫生—泌尿科学]