前列腺癌根治术后拔除尿管时间的meta分析  

Time of urinary catheter removal after radical prostatectomy:a meta-analysis

作　　者：高梦昕 陈媛 华小玲 刘春香 张敏[1] 赵妍[1] 蔡超[1,2] 刘永达 孙红玲[1] GAO Mengxin;CHEN Yuan;HUA Xiaoling;LIU Chunxiang;ZHANG Min;ZHAO Yan;CAI Chao;LIU Yongda;SUN Hongling(Operating Room,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou,510120,China;Guangdong Provincial Key Laboratory of Urology)

机构地区：[1]广州医科大学附属第一医院手术室,广州510120 [2]广东省泌尿外科重点实验室

出　　处：《临床泌尿外科杂志》2023年第7期500-504,509,共6页Journal of Clinical Urology

基　　金：国家自然科学基金(No:82073294);广州市卫生健康科技一般引导项目和两新项目(No:20211A011075)。

摘　　要：目的:系统评价前列腺癌根治术术后不同时间拔除导尿管的临床效果和安全性,探讨术后拔除尿管的最佳时间。方法:计算机检索PubMed、EBSCO、Web of Science、Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普数据库中关于前列腺癌根治术术后导尿管拔除时间对排尿影响的病例对照研究,检索时间为建库至2023年2月。所有文献依据纳入和排除标准筛选,由2名研究者独立完成质量评价,并采用RvMan 5.4软件进行meta分析。结果:纳入6篇文献,涉及5959例患者。Meta分析结果显示,与术后>7 d比较,5~7 d拔除导尿管可以预防术后尿失禁(RR=0.93,95%CI:0.90~0.97,P<0.05),术后2~4 d与5~7 d拔除导尿管对尿失禁发生率的影响差异无统计学意义(RR=1.19,95%CI:0.81~1.73,P=0.37)。前列腺癌根治术后患者拔除导尿管的时间对尿潴留发生率的影响差异无统计学意义(RR=4.38,95%CI:0.61~31.49,P=0.14)。结论:与>7 d比较,术后5~7 d拔除尿管能降低尿失禁的发生率。前列腺癌根治术后5~7 d内拔除导尿管是预防尿失禁发生的最佳时间。Objective To systematically evaluate the clinical effect and safety of different timing of urinary catheter removal after radical prostatectomy,and to explore the best timing of urinary catheter removal after radical prostatectomy.Methods PubMed was searched by computer EBSCO,Web of Science,The Cochrane Library,CNKI,Wanfang,CBM and VIP databases were searched by computer for case-control studies on the effect of different removal time of instillation catheter on urination after radical prostatectomy.The literature was screened according to the inclusion and exclusion criteria,and the quality of the literature was evaluated.RevMan5.4 software was used for meta-analysis.Results Six studies involving 5959 patients were included in the meta-analysis.The results showed that compared with the removal time of urinary catheter>7 days,the removal of urinary catheter within 5-7 days could prevent the occurrence of urinary incontinence(RR=0.93,95%CI:0.90-0.97,P<0.05).There was no significant difference in the incidence of urinary incontinence between 2-4 days and 5-7 days after radical prostatectomy(RR=1.19,95%CI:0.81-1.73,P=0.37).However,there was no significant difference in the incidence of urinary retention among different time of catheter removal after radical prostatectomy(RR=4.38,95%CI:0.61-31.49,P=0.14).Conclusion Compared with catheter removal time>7 days,catheter removal time 5-7 days can reduce the incidence of urinary incontinence.Therefore,the best time to prevent urinary incontinence is to remove the catheter within 5 to 7 days after radical prostatectomy.

关 键 词：前列腺癌根治术 留置导尿管 拔管时间 META分析 

分 类 号：R737.25[医药卫生—肿瘤]