间歇导尿与留置导尿治疗尿潴留的系统评价

Systematic evaluation on intermittent catheterization and indwelling catheterization for treatment of urinary retention

[目的]系统评价间歇导尿与留置导尿治疗尿潴留的有效性和安全性。[方法]采用Cochrane系统评价方法,计算机检索PubMed,EMBASE,Co-chrane图书馆,CBM,CNKI,VIP等数据库,手工检索相关领域的杂志,并用Google Scholar和Medical Martix等搜索引擎在互联网上查找相关文献。收集有关间歇导尿与留置导尿比较治疗尿潴留的随机或半随机对照试验,按照Cochrane系统评价员手册4.2.6版推荐的质量评价标准纳入研究质量,并对同质研究采用RevMan5.1进行Meta分析。[结果]共纳入8个随机对照试验,包括797例病人。2个研究采用随机数字表进行分组,2个研究描述了分配隐藏,2个研究描述了盲法。Meta分析结果显示:间歇导尿组的病人尿路感染人数少于留置导尿组[OR=0.56,95%CI(0.37,0.87)],差异有统计学意义。两组在导尿术一段时间后排尿正常人数[OR=1.48,95%CI(0.74,2.95)]和不适感人数[OR=0.59,95%CI(0.21,1.68)]方面的差异无统计学意义。[结论]现有证据表明,间歇导尿术治疗尿潴留在降低尿路感染方面优于留置导尿,而在导尿术一段时间后排尿正常人数和不适感人数等方面没有证据证明其有优势。

Objective： To evaluate systematically the efficiency and safety between intermittent catheterization and indwelling catheterization for treatment of urinary retention. Methods：By using the Cochrane Systematic evaluation, the PubMed, EMBASE,Cochrane Library, CBM, CNKI, VIP da- tabases were searched by computers, the magazines in the relevant fields were searched by manual searches, and relevant literatures were found by using Google Scholar and Medical Martix search engines on the Internet. Random or quasi - randomized controlled trials were collected about com- parison of treatment of urinary retention between intermittent catheteriza- tion and indwelling catheter,and they were brought into the research quali- ty according to the quality evaluation criteria recommended by the Co- chrane Systematic Review Handbook 4. 2. 6 version, and homogeneous study accepted Meta - analysis by using RevMan 5. 1. Results： A total of eight randomized controlled trials including 797 patients were brought in- to. Two studies were divided in groups by using random number table, and another two studies described allocation concealment, another two studies described blinding. Meta-analysis results showed that： the number of pa- tients with urinary tract infection in intermittent catheterization group was less than that of indwelling catheter group [OR：O. 56,95%CI（0.37,0. 87）], there was statistically significant differences. There was no statistically difference in the normal number of catheterization technique for some time after urinating between the two groups[OR： 1.48,95% CI（0. 74,2.95）] and the number of people wiith discomfort[-OR：0. 59,95% CI（0. 21,1.68）2. Conclusion：The available evidences showed that intermittent catheteriza- tion treatment of urinary retention is better than indwelling catheter in re- ducing urinary tract infection, however, no evidences prove its advantages in the normal urination number and the number of people with discomfort in after catheterization technique for some time.