择期剖宫产围术期不留置尿管有效性和安全性的Meta分析

发布时间：2018-04-01 10:09

本文选题：剖宫产　切入点：留置尿管　出处：《重庆医学》2017年24期

【摘要】：目的系统评价择期剖宫产围术期不留置尿管的有效性和安全性。方法计算机检索Medline(PubMed)、EMbase、The Cochrane Library、OVID、中国知网、万方数据知识服务平台,全面搜集有关择期剖宫产围术期不留置尿管有效性和安全性的随机对照试验(RCT)。由2位研究者独立完成文献筛选,资料提取和质量评价,采用RevMan5.3软件进行Meta分析。结果最终纳入5个RCTs,共1 090例患者。Meta分析结果显示,与留置尿管组相比,不留置尿管组虽然增加了尿潴留发生率[RR=11.67,95%CI(2.22,61.24),P0.01],但是明显降低了UTI发生率[RR=0.10,95%CI(0.04,0.26),P0.01]和初次排尿不适感发生率[RR=0.17,95%CI(0.04,0.74),P=0.02],明显缩短了首次下床活动时间[SMD=-3.68,95%CI(-5.25,-2.12),P0.01]和住院时间[SMD=-1.03,95%CI(-1.67,-0.38),P0.01],两组手术时间[SMD=-0.13,95%CI(-0.32,0.07),P=0.20]和产后出血发生率[RR=1.50,95%CI(0.43,5.26),P=0.53]比较差异无统计学意义,膀胱损伤的发生率相似。结论基于目前临床研究证据,择期剖宫产围术期不留置尿管是有效、安全的,提示剖宫产围术期留置尿管应为选择性而不是常规留置。
[Abstract]:Objective to evaluate the efficacy and safety of non-indwelling catheterization during elective cesarean section. Methods the Cochrane Library OVID was searched by computer. A randomized controlled trial was conducted on the efficacy and safety of non-indwelling urinary catheterization during elective cesarean section. Two researchers independently completed literature screening, data extraction and quality evaluation. RevMan5.3 software was used for Meta analysis. The results were included in 5 RCTs, and 1 090 patients. Meta-analysis results showed that compared with indwelling urethral catheterization group, the results of Meta analysis were compared with that of indwelling urethral catheter group. Although the incidence of urinary retention was increased in the non-indwelling urethral tube group [RRR 11.6795 CII 2.2261.24 P0.01], but the incidence of UTI was significantly reduced [RRR1095CI0.04 0. 26 P0.01] and the first urination discomfort rate [RR0.1795 CI0.040.74 P0.02], significantly shortened the first time off the bed [SMD-3.6895CI-5.25-2.12C0.01] and the hospitalization time [SMD-1.0395CI-0.3875CI-0.38P0.01], and the two groups [SMD-0.1395CI-30.20.07P0. 20] and the two groups were given a significant reduction in the duration of the first bed activity [SMD-3.6895CI-5.25-2.12P0.01] and the duration of hospitalization [SMD-1.0395CI-0.3875CI-0.38P0.01], the two groups had a significant reduction in the duration of the first bed activity [SMD-3.6895CI-5.25-2.12P0.01] and the duration of the two groups [SMD-0.1395CI-30.20.07P0.01]. There was no significant difference in the incidence of postpartum hemorrhage. Conclusion based on the current clinical evidence, no indwelling catheter during elective cesarean section is effective and safe, suggesting that the indwelling catheter should be selective rather than conventional during cesarean section.
【作者单位】：西南医科大学研究生学院护理学院;四川省医学科学院/四川省人民医院护理部;徐州医科大学附属医院护理部;
【基金】：四川省卫生和计划委员会科研课题资助项目(16PJ498)
【分类号】：R473.71

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