留置导尿管拔管前夹闭尿管的必要性探讨
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摘要
[目的]对留置导尿管病人拔管前夹闭导尿管的必要性进行文献循证,为临床实践提供依据。[方法]检索2007年—2017年发表的中英文文献,研究类型限定为随机对照实验(RCT)或准随机对照实验(quasi-RCT)。对纳入文献按导管留置时间及夹管程序进行分类效果分析及方法学评价。[结果]共纳入12篇文献,包括9篇RCT和3篇quasi-RCT。夹闭程序可分为充盈式拔管和训练式拔管。充盈式拔管临床效果无一致结论,短期置管病人训练式拔管引发的并发症更多。纳入的多数文献方法学设计存在缺陷,需更多设计严谨的研究来验证拔管前夹闭导管的必要性。[结论]现有证据表明,短期置管病人拔管前不必要常规实施训练式拔管。充盈式拔管及长期置管病人训练式拔管的必要性尚需进一步研究。
Objective:To evaluate the necessity of clamping catheter prior to removal in patients with indwelling urinary catheters(IUC)so as to provide an evidence basis for clinical practice.Methods:The literature published in Chinese and English journals between 2007 and 2017were searched.The study methodology was limited to randomized controlled trial(RCT)or quasi-randomized controlled trial(quasi-RCT).According to the catheterization duration of IUC and the clamping procedure,the findings of the included studies were analyzed,together with evaluating their methodological quality.Results:A total of 12 studies were included in this literature review,consisting of nine RCTs and three quasi-RCTs.The clamping procedure can be divided into filling removal and training removal.There was no consensus about the clinical effectiveness of filling removal.More complications were reported when training removal was implemented among patients with short-term IUC.The methodological design of the majority of the included studies was problematic.More rigorous research is needed to verify the necessity of clamping catheter before removing IUC.Conclusions:It is not necessary to routinely implement training removal for patients with short-term IUC.Further study is needed to evaluate the necessity of filling removal and training removal for patients with long-term IUC.
Objective:To evaluate the necessity of clamping catheter prior to removal in patients with indwelling urinary catheters(IUC)so as to provide an evidence basis for clinical practice.Methods:The literature published in Chinese and English journals between 2007 and 2017were searched.The study methodology was limited to randomized controlled trial(RCT)or quasi-randomized controlled trial(quasi-RCT).According to the catheterization duration of IUC and the clamping procedure,the findings of the included studies were analyzed,together with evaluating their methodological quality.Results:A total of 12 studies were included in this literature review,consisting of nine RCTs and three quasi-RCTs.The clamping procedure can be divided into filling removal and training removal.There was no consensus about the clinical effectiveness of filling removal.More complications were reported when training removal was implemented among patients with short-term IUC.The methodological design of the majority of the included studies was problematic.More rigorous research is needed to verify the necessity of clamping catheter before removing IUC.Conclusions:It is not necessary to routinely implement training removal for patients with short-term IUC.Further study is needed to evaluate the necessity of filling removal and training removal for patients with long-term IUC.
引文
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[12]钟小蓉.拔除留置尿管的时机对排尿的影响[J].实用护理杂志,1999,15(4):36-37.
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[17]WILLIAMSON M L.Reducing post-catheterization bladder dysfunction by reconditioning[J].Nursing Research,1982,31(1):28-30.
[18]OBERST M T,GRAHAM D,GELLER N L.Catheter management programs and postoperative urinary dysfunction[J].Research in Nursing&Health,1981,4(1):175-181.
[19]ROE B.Do we need to clamp catheters?[J].Nursing Times,1990,86(43):66-67.
[20]GRIFFITHS R,FERNANDEZ R.Strategies for the removal of short-term indwelling urethral catheters in adults[J].The Cochrane Database of Systematic Reviews,2007(2):CD004011.
[21]Joanna Briggs Institute.Removal of short-term indwelling urethral catheters.This article has been reproduced with the permission of the Joanna Briggs Institute(JBI)[J].Nursing Standard,2008,22(22):42-45.
[22]苏淑芬,王秋杏.腹式全宫切除术后拔除尿管最佳时机探讨[J].当代护士,2012(8):56-57.
[23]孙燕.术后不同拔除尿管方式对病人排尿的影响[J].中外医学研究,2012,10(27):87.
[24]杨京春,刘名名.尿管夹闭练习对脊柱术后病人拔除尿管的影响[J].护士进修杂志,2011,26(15):1407-1409.
[25]胡晓昀,李秀萍,方海云,等.术后短期留置尿管病人拔管前夹闭尿管必要性的研究[J].中华护理杂志,2013,48(3):269-270.
[26]马华,陈妮,禹璐,等.全麻术后短期留置尿管拔管前夹闭尿管必要性的探讨[J].临床医学研究与实践,2016,1(26):183-184.
[27]谢凤兰,何翠环,肖萍,等.两种不同拔尿管方法的比较[J].现代临床护理,2009,8(11):20-21.
[28]GONG Y,ZHAO L,WANG L,et al.The effect of clamping the indwelling urinary catheter before removal in cervical cancer patients after radical hysterectomy[J].Journal of Clinical Nursing,2017,26(7/8):1131-1136.
[29]MOON H J,CHUN M H,LEE S J,et al.The usefulness of bladder reconditioning before indwelling urethral catheter removal from stroke patients[J].American Journal of Physical Medicine&Rehabilitation,2012,91(8):681-688.
[30]LIU Y S,WEI S,ELLIOTT M.The effects of a catheter clamping protocol on bladder function in neurosurgical patients:a controlled trial[J].International Journal of Nursing Practice,2015,21(1):29-36.
[31]ZHENG Y Y,CHANGXIAO H,SHIBING Y,et al.Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia[J].Scandinavian Journal of Urology,2014,48(4):400-404.
[32]FANFANI F,COSTANTINI B,MASCILINI F,et al.Early postoperative bladder training in patients submitted to radical hysterectomy:is it still necessary?A randomized trial[J].Archives of Gynecology and Obstetrics,2015,291(4):883-888.
[33]EDMOND L.A brief literature search and clinical audit of postoperative urinary retention following total point replacement[J].Journal of Orthopaedic Nursing,2006,10(2):67-72.
[34]JACOBSEN K H.Introduction to health research methods[D].Burlington:Jones&Bartlett Publishers,2016.
[2]LAM T B L,OMAR M I,Fisher E.Types of indwelling urethral catheters for short-term catheterisation in hospitalised adults[J].The Cochrane Database of Systematic Reviews,2014(9):CD004013.
[3]COLLI J,TOJUOLA B,PATTERSON A L.National trends in hospitalization from indwelling urinary catheter complications,2001-2010[J].International Urology and Nephrology,2014,46(2):303-308.
[4]FENELEY R C L,HOPLEY I B,WELLS P N T.Urinary catheters:history,current status,adverse events and research agenda[J].Journal of Medical Engineering&Technology,2015,39(8):459-470.
[5]REUVERS S.Indwelling urinary catheter-related problems after laparoscopic radical prostatectomy[J].Journal of Wound,Ostomy,and Continence Nursing:Official Publication of the Wound,Ostomy and Continence Nurses Society,2016,43(4):420-424.
[6]HOOTON T M,BRADLEY S F,CARDENAS D D,et al.Diagnosis,prevention,and treatment of catheter-associated urinary tract infection in adults:2009international clinical practice guidelines from the infectious diseases society of America[J].Clinical Infectious Diseases,2010,50(5):625-663.
[7]LOVEDAY H P,WILSON J A,PRATT R J,et al.National evidence-based guidelines for preventing healthcareassociated infections in NHS hospitals in England[J].The Journal of Hospital Infection,2014,86(Suppl 1):S1-S70.
[8]LYNCH G,BELL K,LONG D,et al.Factors associated with the successful removal of indwelling urinary catheters post-operatively in the fragility hip fracture patient[J].International Journal of Orthopaedic and Trauma Nursing,2016,23(1):25-31.
[9]DUNN S V,PRETTY L,REID H,et al.Management of short term indwelling urethral catheters to prevent urinary tract infections[D].Adelaide:The Joanna Briggs Institute for Evidence Based Nursing and Midwifery,2000.
[10]MOOLA S,KONNO R.A systematic review of the management of short-term indwelling urethral catheters to prevent urinary tract infections[J].JBI Library of Systematic Reviews,2010,8(17):695-729.
[11]Fillingham S,Douglas J.Urological nursing[D].London(UK):Bailliere Tindall,2005.
[12]钟小蓉.拔除留置尿管的时机对排尿的影响[J].实用护理杂志,1999,15(4):36-37.
[13]李惠玲,李淑蓉,刘淑蓉.拔除留置尿管时机对减少尿潴留的临床研究[J].护士进修杂志,2002,17(6):417-418.
[14]ROSS J.Some observations on the indwelling catheter[J].Practitioner,1936,136(638):e44.
[15]NYMAN M H,JOHANSSON J,GUSTAFSSON M.Arandomied controlled trial on the effect of clamping the indwelling urinary catheter in patients with hip fracture[J].Journal of Clinical Nursing,2010,19(3/4):405-413.
[16]龚春兰,黄家诚,罗秀菊.胸外科术后留置尿管拔除时机对尿潴留的影响[J].中国实用护理杂志,2005,21(4):405-413.
[17]WILLIAMSON M L.Reducing post-catheterization bladder dysfunction by reconditioning[J].Nursing Research,1982,31(1):28-30.
[18]OBERST M T,GRAHAM D,GELLER N L.Catheter management programs and postoperative urinary dysfunction[J].Research in Nursing&Health,1981,4(1):175-181.
[19]ROE B.Do we need to clamp catheters?[J].Nursing Times,1990,86(43):66-67.
[20]GRIFFITHS R,FERNANDEZ R.Strategies for the removal of short-term indwelling urethral catheters in adults[J].The Cochrane Database of Systematic Reviews,2007(2):CD004011.
[21]Joanna Briggs Institute.Removal of short-term indwelling urethral catheters.This article has been reproduced with the permission of the Joanna Briggs Institute(JBI)[J].Nursing Standard,2008,22(22):42-45.
[22]苏淑芬,王秋杏.腹式全宫切除术后拔除尿管最佳时机探讨[J].当代护士,2012(8):56-57.
[23]孙燕.术后不同拔除尿管方式对病人排尿的影响[J].中外医学研究,2012,10(27):87.
[24]杨京春,刘名名.尿管夹闭练习对脊柱术后病人拔除尿管的影响[J].护士进修杂志,2011,26(15):1407-1409.
[25]胡晓昀,李秀萍,方海云,等.术后短期留置尿管病人拔管前夹闭尿管必要性的研究[J].中华护理杂志,2013,48(3):269-270.
[26]马华,陈妮,禹璐,等.全麻术后短期留置尿管拔管前夹闭尿管必要性的探讨[J].临床医学研究与实践,2016,1(26):183-184.
[27]谢凤兰,何翠环,肖萍,等.两种不同拔尿管方法的比较[J].现代临床护理,2009,8(11):20-21.
[28]GONG Y,ZHAO L,WANG L,et al.The effect of clamping the indwelling urinary catheter before removal in cervical cancer patients after radical hysterectomy[J].Journal of Clinical Nursing,2017,26(7/8):1131-1136.
[29]MOON H J,CHUN M H,LEE S J,et al.The usefulness of bladder reconditioning before indwelling urethral catheter removal from stroke patients[J].American Journal of Physical Medicine&Rehabilitation,2012,91(8):681-688.
[30]LIU Y S,WEI S,ELLIOTT M.The effects of a catheter clamping protocol on bladder function in neurosurgical patients:a controlled trial[J].International Journal of Nursing Practice,2015,21(1):29-36.
[31]ZHENG Y Y,CHANGXIAO H,SHIBING Y,et al.Randomized controlled trial on the efficacy of bladder training before removing the indwelling urinary catheter in patients with acute urinary retention associated with benign prostatic hyperplasia[J].Scandinavian Journal of Urology,2014,48(4):400-404.
[32]FANFANI F,COSTANTINI B,MASCILINI F,et al.Early postoperative bladder training in patients submitted to radical hysterectomy:is it still necessary?A randomized trial[J].Archives of Gynecology and Obstetrics,2015,291(4):883-888.
[33]EDMOND L.A brief literature search and clinical audit of postoperative urinary retention following total point replacement[J].Journal of Orthopaedic Nursing,2006,10(2):67-72.
[34]JACOBSEN K H.Introduction to health research methods[D].Burlington:Jones&Bartlett Publishers,2016.