夹管训练对术后短期留置尿管病人排尿影响的Meta分析
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摘要
[目的]系统评价夹管训练对术后短期留置尿管病人排尿功能的影响。[方法]计算机检索MedLine,EMbase,CINAHL,PubMed,Cochrane Centetral Register of Controlled Trials(CENTRAL)、中国生物医学文献数据库(CBM)、中国知网(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库,收集术后短期留置尿管病人采取夹管训练与持续开放引流的随机对照试验(RCT),评价纳入文献的质量,并提取资料,应用RevMan 5. 3软件进行Meta分析。[结果]共纳入10篇RCT文献。Meta分析结果显示:两组病人首次排尿时间[SMD=-0. 15,95%CI(-0. 67,0. 37)]、尿路刺激征发生率[OR=0. 33,95%CI(0. 09,1. 23)]、尿潴留发生率[OR=0. 80,95%CI(0. 53,1. 19)]、尿路感染发生率[OR=0. 95,95%CI(0. 61,1. 47)]均无统计学差异(P>0. 05)。[结论]术后短期留置尿管病人进行夹管训练没有缩短首次排尿时间和减少尿路刺激征、尿潴留和尿路感染的发生率,提示短期留置尿管期间可不必夹管训练。
Objective:To systematically evaluate the effect of pinch training on urinary function in patients with a short-term indwelling catheter.Methods:The randomized controlled trials(RCTs) of pinch training and continuous open drainage that performed in patients with short-term indwelling catheters were retrieved from MedLine, EMbase, CINAHL, PubMed, Cochrane Central Register of Controlled Trials(CENTRAL), China Biomedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), VIP Journal Integration Platform(VJIP),and Wanfang Database.The quality of the included literature was evaluated and data were extracted.Metaanalysis was performed by using RevMan 5.3 software.Results:A total of 10 RCT literature were included in this study.The results of the meta-analysis showed that the first time of urination in the two groups[SMD=-0.15,95%CI(-0.67,0.37)],the incidence of urinary tract irritation[OR=0.33, 95%CI(0.09, 1.23)], the incidence of urine retention[OR=0.80, 95%CI(0.53, 1.19)] the incidence of urinary tract infection[OR=0.95, 95%CI(0.61, 1.47)]were not statistically significant(P>0.05).Conclusion:Pinch training for patients with short-term indwelling urethral surgery did not shorten the time of first urination or reduce the incidence of urinary tract irritation, urinary retention and urinary tract infection,suggesting that there was no need for pinch training during short-term indwelling catheter.
Objective:To systematically evaluate the effect of pinch training on urinary function in patients with a short-term indwelling catheter.Methods:The randomized controlled trials(RCTs) of pinch training and continuous open drainage that performed in patients with short-term indwelling catheters were retrieved from MedLine, EMbase, CINAHL, PubMed, Cochrane Central Register of Controlled Trials(CENTRAL), China Biomedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), VIP Journal Integration Platform(VJIP),and Wanfang Database.The quality of the included literature was evaluated and data were extracted.Metaanalysis was performed by using RevMan 5.3 software.Results:A total of 10 RCT literature were included in this study.The results of the meta-analysis showed that the first time of urination in the two groups[SMD=-0.15,95%CI(-0.67,0.37)],the incidence of urinary tract irritation[OR=0.33, 95%CI(0.09, 1.23)], the incidence of urine retention[OR=0.80, 95%CI(0.53, 1.19)] the incidence of urinary tract infection[OR=0.95, 95%CI(0.61, 1.47)]were not statistically significant(P>0.05).Conclusion:Pinch training for patients with short-term indwelling urethral surgery did not shorten the time of first urination or reduce the incidence of urinary tract irritation, urinary retention and urinary tract infection,suggesting that there was no need for pinch training during short-term indwelling catheter.
引文
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[15]SUN M J,CHANG S Y,LIN K C,et al.Is an indwelling catheter necessary for bladder drainage after modified burch colposuspension[J].Int Urogynecol J Pelvic Floor Dysfunct,2004,5(3):203-207.
[16]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].Arch Gynecol Obstet,2015,291:883-888.
[17]陈亚萍.脊柱侧弯患者术后短期留置尿管期间夹闭尿管效果的研究[D].北京:北京协和医学院,2013.
[18]严素琴.子宫切除术后患者拔除尿管前夹闭尿管的必要性[J].国际护理学杂志,2017,36(17):2443-2444.
[19]FILLINGHAM S,DOUGLAS J.Urological nursing[M].3rd ed.London(UK):Bailliere Tindall,2005:1.
[20]GETLIFFE K.Care of urinary catheters[J].Elder Care,1996,8(2):23-26.
[21]COLLI J,TOJUOLA B,PATTERSON A,et al.National trends in hospitalization from indwelling urinary catheter complications,2001-2010[J].Int Urol Nephrol,2014,46(2):303-308.
[22]FERNANDEZ R S,GRIFFITHS R D.Clamping short-term indwelling catheters,a systematic review of the evidence[J].JWound Ostomy Cont,2005,32(5):329-336.
[23]LORZADEH N,KAZEMIRAD S,LORZADEH M.Urinary retention following the gynecologic surgeries and effect of Foley catheter clamping on its prophylaxis[J].J Med Sci,2007,7(8):1358-1361.
[2]NYMAN M,JOHANSSON J,GUSTAFSSON M.A randomized controlled trial on the effect of clamping the indwelling urinary catheter in patients with hip fracture[J].J Clin Nurs,2010,19:405-413.
[3]SAINT S.Clinical and economic consequences of nosocomial catheter-related bacteriuria[J].Am J Infect Control,2000,28(1):68-75.
[4]WARREN D K,QUADIR W W,HOLLENBEAK C S,et al.Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital[J].Crit Care Med,2006,34(8):2084-2089.
[5]AGARWAL B K,AGARWAL N.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].Scand J Urol,2014,48(4):400-404.
[6]ROSS J.Some observations on the indwelling catheter[J].Practitioner,1936,136:638-644.
[7]ROE B.Do we need to clamp catheters?[J].Nurs Times,1990,86(43):66-67.
[8]李小平,王克芳,段功香.基础护理学[M].北京:人民卫生出版社,2007:205.
[9]胡晓昀,李秀萍,方海云,等.术后短期留置尿管患者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.
[10]CROWE H,CLIFT R,DUGGAN G,et al.A randomized study of the effect of midnight removal of urinary catheters[J].Urol Nurs,1994,14(1):18-20.
[11]OBERST M,GRAHAM D,GELLER N,et al.Catheter management programs and postoperative urinary dysfunction[J].Res Nurs Health,1981,4:175-181.
[12]BERGMAN A,MATTHEWS L,BALLARD C A.Bladder training after surgery for stress urinary incontinence:is it necessary?[J].Obstet Gynecol,1987,70(6):909-912.
[13]GUZMAN S,ISRAEL E,PUENTE R,et al.Handling of Foley catheter regarding urinary retention syndrome following vaginal surgery[J].Revista Chilena de Obstetricia Ginecologia,1994,59(4):280-283.
[14]RATNAVAL C D,RENWICK P,FAROUK R,et al.Suprapubic versus transurethral catheterization of males undergoing pelvic colorectal surgery[J].Int J Colorectal Dis,1996,11(4):177-179.
[15]SUN M J,CHANG S Y,LIN K C,et al.Is an indwelling catheter necessary for bladder drainage after modified burch colposuspension[J].Int Urogynecol J Pelvic Floor Dysfunct,2004,5(3):203-207.
[16]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].Arch Gynecol Obstet,2015,291:883-888.
[17]陈亚萍.脊柱侧弯患者术后短期留置尿管期间夹闭尿管效果的研究[D].北京:北京协和医学院,2013.
[18]严素琴.子宫切除术后患者拔除尿管前夹闭尿管的必要性[J].国际护理学杂志,2017,36(17):2443-2444.
[19]FILLINGHAM S,DOUGLAS J.Urological nursing[M].3rd ed.London(UK):Bailliere Tindall,2005:1.
[20]GETLIFFE K.Care of urinary catheters[J].Elder Care,1996,8(2):23-26.
[21]COLLI J,TOJUOLA B,PATTERSON A,et al.National trends in hospitalization from indwelling urinary catheter complications,2001-2010[J].Int Urol Nephrol,2014,46(2):303-308.
[22]FERNANDEZ R S,GRIFFITHS R D.Clamping short-term indwelling catheters,a systematic review of the evidence[J].JWound Ostomy Cont,2005,32(5):329-336.
[23]LORZADEH N,KAZEMIRAD S,LORZADEH M.Urinary retention following the gynecologic surgeries and effect of Foley catheter clamping on its prophylaxis[J].J Med Sci,2007,7(8):1358-1361.