神经源性膀胱上尿路损害风险管理的最佳证据总结
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摘要
[目的]检索、评价和获取神经源性膀胱病人上尿路损害预防及管理的最佳证据。[方法]计算机检索BMJ最佳临床实践、UpToDate、Cochrane Library、JBI循证卫生保健国际合作中心图书馆、英国国家临床医学研究所指南库、PubMed、EMbase、MedLine、Web of Science、中国生物医学文献服务系统、中国知网、万方数据库关于神经源性膀胱病人上尿路损害预防及管理的相关证据,包括指南、证据总结、最佳临床实践信息册、推荐实践、系统评价及原始研究。由2名研究者对纳入的文献质量进行评价,并对符合质量标准的文献进行证据提取。[结果]共纳入17篇文献,其中指南2篇、系统评价5篇、随机对照试验5篇、类试验研究4篇、观察性研究1篇,从导尿术管理、预防泌尿系感染管理、改善排尿相关神经肌肉功能方法、健康教育4个方面共总结了20条最佳证据。[结论]最佳证据总结为临床医务人员护理干预提供了循证依据,护理人员通过科学的护理方法管理成人上尿路损害问题,进一步提升护理质量。
Objective:To retrieve, evaluate, and obtain the best evidences for the prevention and management of upper urinary tract injury in patients with neurogenic bladder(NGB).Methods:Literatures about the relevant evidences for the prevention and management of upper urinary tract injury in NGB patients were retrieved from BMJ best clinical practice,UpToDate,Cochrane Library,JBI EvidenceBased Health Care International Cooperation Center Library, UK National Institute of Clinical Medicine Guide Library, PubMed,EMbase, MedLine, Web of Science, Chinese Biomedical Literature, China National Knowledge Infrastructure(CNKI), and Wanfang Database,including guidelines,evidence summary,best clinical practice information booklet,recommended practice,systematic review,and original research.Two investigators evaluated the quality of the included literatures and extracted evidences from documents that met the quality criteria.Results:A total of 17 articles were included,including 2 articles,5 systematic reviews,5 randomized controlled trials,4 experimental studies, and 1 observational study. A total of 20 best evidences were summarized in four aspects: urinary catheterization management, prevention of urinary tract infection management, improvement methods of urinary-related neuromuscular function, and health education.Conclusions:The summary of the best evidences provided evidence-based evidence for clinical medical staff's nursing intervention.Adopting scientific nursing methods to manage the upper urinary tract injury problem in adults could improve the quality of care further.
Objective:To retrieve, evaluate, and obtain the best evidences for the prevention and management of upper urinary tract injury in patients with neurogenic bladder(NGB).Methods:Literatures about the relevant evidences for the prevention and management of upper urinary tract injury in NGB patients were retrieved from BMJ best clinical practice,UpToDate,Cochrane Library,JBI EvidenceBased Health Care International Cooperation Center Library, UK National Institute of Clinical Medicine Guide Library, PubMed,EMbase, MedLine, Web of Science, Chinese Biomedical Literature, China National Knowledge Infrastructure(CNKI), and Wanfang Database,including guidelines,evidence summary,best clinical practice information booklet,recommended practice,systematic review,and original research.Two investigators evaluated the quality of the included literatures and extracted evidences from documents that met the quality criteria.Results:A total of 17 articles were included,including 2 articles,5 systematic reviews,5 randomized controlled trials,4 experimental studies, and 1 observational study. A total of 20 best evidences were summarized in four aspects: urinary catheterization management, prevention of urinary tract infection management, improvement methods of urinary-related neuromuscular function, and health education.Conclusions:The summary of the best evidences provided evidence-based evidence for clinical medical staff's nursing intervention.Adopting scientific nursing methods to manage the upper urinary tract injury problem in adults could improve the quality of care further.
引文
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[26]张秀淋.间歇性清洁导尿在神经源性膀胱功能障碍患者中的应用[J].广州医学院学报,2012,40(6):66-68.ZHANG X L.Clean intermittent catheterization in patients with neurogenic bladder dysfunction[J].Academic Journal of Guangzhou Medical College,2012,40(6):66-68.
[27]徐秀梅,徐彦龙.康复训练结合针灸治疗脊髓损伤神经源性膀胱患者临床疗效观察[J].中国针灸,2015,35(7):670-673.XU X M,XU Y L.Clinical efficacy on neurogenic bladder after spinal cord injury treated with rehabilitation training and acupuncturemoxibustion[J].Chinese Acupuncture&Moxibustion,2015,35(7):670-673.
[28]刘铁军,沙可夫,赵盟杰,等.相对安全膀胱容量间歇导尿法保护上尿路的临床研究[J].中国康复理论与实践,2010,16(8):792-793.LIU T J,SHA K F,ZHAO M J,et al.Intermittent catheterization by relative safe bladder capacity to treat vesical-ureteral reflux[J].Chinese Journal of Rehabilitation Theory and Practice,2010,16(8):792-793.
[29]王红霞,张善欣.系统健康教育在神经源性膀胱患者中的应用[J].齐鲁护理杂志,2017,23(15):121-122.WANG H X,ZHANG S X.Application of systematic health education in patients with neurogenic bladder[J].Journal of Qilu Nursing,2017,23(15):121-122.
[30]张国锋,梁英,王莹.清洁间歇性导尿技术配合饮水计划在神经源性膀胱病人中的应用[J].全科护理,2017,15(16):1996-1998.ZHANG G F,LIANG Y,WANG Y.Clean intermittent catheterization technology with drinking water plan application in patients with neurogenic bladder[J].Chinese General Practice Nursing,2017,15(16):1996-1998.
[31]蒋玮,张茂舒,谭波涛,等.盆底肌生物反馈电刺激对脊髓损伤后神经源性膀胱功能恢复的临床研究[J].第三军医大学学报,2014,36(16):1725-1728.JIANG W,ZHANG M S,TAN B T,et al.Effects of pelvic biofeedback electrical stimulation on neurogenic bladder in patients with spinal cord injury[J].Journal of Third Military Medical University,2014,36(16):1725-1728.
[32]CHANG S M,HOU C L,DONG D Q,et al.Urologic status of 74spinal cord injury patients from the 1976 Tangshan earthquake,and managed for over 20 years using the crede maneuver[J].Spinal Cord,2000,38(9):552-554.
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[2]刘庆军,陈永骞,田野,等.74例神经源性膀胱输尿管反流肾积水的治疗分析[J].现代泌尿外科杂志,2010,15(5):364-366.LIU Q J,CHEN Y Q,TIAN Y,et al.Treatment of vesicoureteral reflux caused by neurological bladder[J].Journal of Modern Urology,2010,15(5):364-366.
[3]文建国,姚亚雄,张国贤,等.小儿神经源性膀胱不同充盈期顺应性与上尿路扩张的关系研究[J].临床泌尿外科杂志,2012,27(2):124-130.WEN J G,YAO Y X,ZHANG G X,et al.The study on the relationship between bladder compliance and detrusor pressure at different bladder filling stages and upper urinary tract dilatation[J].Journal of Clinical Urology,2012,27(2):124-130.
[4]HVH Z,GRANGER N,JEFFERY N D,et al.Pathophysiology,Clinical importance,and management of neurogenic lower urinary tract dysfunction caused by suprasacral spinal cord injury[J].Journal of Veterinary Internal Medicine,2016,30(5):1575-1588.
[5]?EKER?A,ISBILEN B,ISMAN F,et al.Urinary NGF,TGF-β1,TIMP-2 and bladder wall thickness predict neurourological findings in children with myelodysplasia[J].The Journal of Urology,2014,191(1):199-205.
[6]HAMID R,AVERBECK M A,CHIANG H,et al.Epideriology and pathophysiology of neurogenic bladder after spinal cord injury[J].World Journal of Urology,2018,36(10):1517-1527.
[7]WYNDAELE J.Complications of intermittent catheterization:their prevention and treatment[J].Spinal Cord,2002,40(10):536-541.
[8]LúCIO A C,CAMPOS R M,PERISSINOTTO M C,et al.Pelvic floor muscle training in the treatment of lower urinary tract dysfunction in women with multiple sclerosis[J].Neurourology and Urodynamics,2010,29(8):1410-1413.
[9]栾秀香,王丽华.脊髓损伤致神经源性膀胱患者饮水计划的实施[J].中国伤残医学,2014,22(2):80-81.LUAN X X,WANG L H.Implementation of drinking water plan for patients with neurogenic bladder caused by spinal cord injury[J].Chinese Journal of Trauma and Disability Medicine,2014,22(2):80-81.
[10]蒋东生,车兴旺,范连彬.生物反馈技术结合膀胱功能训练治疗脊髓损伤患者排尿障碍[J].临床医学,2012,32(8):54-56.JIANG D S,CHE X W,FAN L B,et al.Biofeedback technology combind with bladder function training for urinary dysfunction in patients with spinal cord injury[J].Clinical Medicine,2012,32(8):54-56.
[11]BROUWERS M C,KHO M E,BROWMAN G P,et al.AGREEⅡ:advancing guideline development,reporting,and evaluation in health care[J].Preventive Medicine,2010,51(5):421-424.
[12]熊俊,陈日新.系统评价/Meta分析方法学质量的评价工具AMSTAR[J].中国循证医学杂志,2011,11(9):1084-1089.XIONG J,CHEN R X.An introduction to a measurement tool to assess the methodological quality of systematic reviews/metaanalysis:AMSTAR[J].Chinese Journal of Evidence-Based Medicine,2011,11(9):1084-1089.
[13]JADAD A R,MOORE R A,CARROLL D,et al.Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J].Controlled Clinical Trials,1996,17(1):1-12.
[14]The Joanna Briggs Institute(JBI).Eritical appraisal checklist for systematic reviews and research syntheses[EB/OL].(2016-07-15)[2018-05-14].http://joannabriggs.org/research/criticalappraisal-tools.html.
[15]WELLS G A,SHEA B,CONNELL D O,et al.NewcastleOttawa Scale(NOS)for assessing the quality of non-randomized studies in meta-analysis[EB/OL].[2012-06-15].http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
[16]蔡文智,孟玲,李秀云.神经源性膀胱护理实践指南(2017年版)[J].护理学杂志,2017,32(24):1-7.CAI W Z,MENG L,LI X Y.Guide to neurogenic bladder care practices(2017 edition)[J].Journal of Nursing Science,2017,32(24):1-7.
[17]GROEN J,PANNEK J,DIAZ DC,et al.Summary of European association of urology(EAV)guidelines on neuro-urology[J].European Associator of Urology,2016,69(2):324-333.
[18]LI L,YE W,RUAN H,et al.Impact of hydrophilic catheters on urinary tract infections in people with spinal cord injury:systematic review and meta-analysis of randomized controlled trials[J].Archives of Physical Medicine and Rehabilitation,2013,94(4):782-787.
[19]ROMO P G B,SMITH C P,COX A,et al.Non-surgical urologic management of neurogenic bladder after spinal cord injury[J].World Journal of Urology,2018,36(10):1555-1568.
[20]ZHANG T,LIU H,LIU Z S,et al.Acupuncture for neurogenic bladder due to spinal cord injury:a systematic review protocol[J].BMJ Open,2014,4(9):e006249.
[21]PRZYDACZ M,CHLOSTA P,CORCOS J.Recommendations for urological follow-up of patients with neurogenic bladder secondary to spinal cord injury[J].International Urology and Nephrology,2018,50(6):1005-1016.
[22]JAGGI A,FATOYE F.Real world treatment patterns in the neurogenic bladder population:a systematic literature review[J].Transl Androl Urol,2017,6(6):1175-1183.
[23]石丹,王维,邸金娜.间歇清洁导尿在脊髓损伤伴神经源性膀胱患者康复中的作用[J].辽宁医学院学报,2011,32(3):260-261.SHI D,WANG W,DI J N.The role of intermittent clean cathterization in the rehabilitation of patients with spinal cord injury and neurogenic bladder[J].Journal of Liaoning Medical University,2011,32(3):260-261.
[24]鄢茵,管细红,童华章.经皮神经电刺激联合膀胱功能再训练对神经源性膀胱功能恢复的影响[J].全科护理,2016,14(15):1530-1532.YAN Y,GUAN X H,TONG H Z.Influence of percutaneous nerve electrical stimulation in combination with bladder function retraining on function recovery of patients with neurogenic bladder[J].Chinese General Practice Nursing,2016,14(15):1530-1532.
[25]吴红琴,张兰香,王速敏.自我清洁间歇导尿在脊髓损伤神经源性膀胱患者中的应用[J].护理学杂志,2014,29(16):77-79.WU H Q,ZHANG L X,WANG S M.Application of clean intermittent self-catheterization in patients with spinal cord injury[J].Journal of Nursing Science,2014,29(16):77-79.
[26]张秀淋.间歇性清洁导尿在神经源性膀胱功能障碍患者中的应用[J].广州医学院学报,2012,40(6):66-68.ZHANG X L.Clean intermittent catheterization in patients with neurogenic bladder dysfunction[J].Academic Journal of Guangzhou Medical College,2012,40(6):66-68.
[27]徐秀梅,徐彦龙.康复训练结合针灸治疗脊髓损伤神经源性膀胱患者临床疗效观察[J].中国针灸,2015,35(7):670-673.XU X M,XU Y L.Clinical efficacy on neurogenic bladder after spinal cord injury treated with rehabilitation training and acupuncturemoxibustion[J].Chinese Acupuncture&Moxibustion,2015,35(7):670-673.
[28]刘铁军,沙可夫,赵盟杰,等.相对安全膀胱容量间歇导尿法保护上尿路的临床研究[J].中国康复理论与实践,2010,16(8):792-793.LIU T J,SHA K F,ZHAO M J,et al.Intermittent catheterization by relative safe bladder capacity to treat vesical-ureteral reflux[J].Chinese Journal of Rehabilitation Theory and Practice,2010,16(8):792-793.
[29]王红霞,张善欣.系统健康教育在神经源性膀胱患者中的应用[J].齐鲁护理杂志,2017,23(15):121-122.WANG H X,ZHANG S X.Application of systematic health education in patients with neurogenic bladder[J].Journal of Qilu Nursing,2017,23(15):121-122.
[30]张国锋,梁英,王莹.清洁间歇性导尿技术配合饮水计划在神经源性膀胱病人中的应用[J].全科护理,2017,15(16):1996-1998.ZHANG G F,LIANG Y,WANG Y.Clean intermittent catheterization technology with drinking water plan application in patients with neurogenic bladder[J].Chinese General Practice Nursing,2017,15(16):1996-1998.
[31]蒋玮,张茂舒,谭波涛,等.盆底肌生物反馈电刺激对脊髓损伤后神经源性膀胱功能恢复的临床研究[J].第三军医大学学报,2014,36(16):1725-1728.JIANG W,ZHANG M S,TAN B T,et al.Effects of pelvic biofeedback electrical stimulation on neurogenic bladder in patients with spinal cord injury[J].Journal of Third Military Medical University,2014,36(16):1725-1728.
[32]CHANG S M,HOU C L,DONG D Q,et al.Urologic status of 74spinal cord injury patients from the 1976 Tangshan earthquake,and managed for over 20 years using the crede maneuver[J].Spinal Cord,2000,38(9):552-554.
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