盐酸利多卡因凝胶用于前列腺增生症留置导尿术的Meta分析

Meta- analysis on application of lidocaine hydrochloride gel in retention catheterization for patients with benign prostatic hyperplasia

目的：探讨盐酸利多卡因凝胶与常规导尿方法在行前列腺增生患者导尿术中的效果及安全性差异。方法：检索国内盐酸利多卡因凝胶（试验组）与常规导尿方法（对照组）在前列腺增生患者导尿术中的临床随机对照研究,检索时限至2014年12月,应用循证医学方法对查阅到的8篇文献进行系统护理学评估。结果：试验组一次置管成功明显多于对照组[OR合并=7.78,95%CI（5.2~11.7）];试验组对尿道黏膜损伤率明显少于对照组[OR合并=0.23,95%CI（0.15~0.39）],试验组尿道刺激反应程度（或疼痛程度）明显轻于对照组[OR合并=0.19,95%CI（0.13~0.27）]。结论：在行前列腺增生患者导尿术时采用盐酸利多卡因凝胶作为麻醉润滑剂不仅可以提高一次置管成功率,还能够减少患者尿道黏膜损伤,减轻患者痛苦和不适感,值得临床推广。

Objective： To discuss effects and security differences of lidocaine hydrochloride gel and conventional catheterization method in retention catheterization for patients with benign prostatic hyperplasia. Methods： Searched clinical randomized controlled trial of lidocaine hydrochloride gel（ experimental group） and conventional catheterization method（ control group） in retention catheterization for patients with benign prostatic hyperplasia with a time limit up to December 2014. Appliedevidence- based medicine method in systemized nursing assessment of the 8 searched papers. Results： Experimental group had more success one- time catheterizations than control group,[OR total = 7. 78,95% CI（ 5. 2- 11. 7） ]; experimental group had smaller rate of urethral mucosa damage than control group,[OR total = 0. 23,95% CI（ 0. 15- 0. 39） ]; urethral stimulation degrees（ or pain degrees） of experimental group patients were slighter than those of control group patients,[OR total = 0. 19,95% CI（ 0. 13- 0. 27） ]. Conclusion： Applying lidocaine hydrochloride gel as anesthetic lubricant in catheterization for patients with benign prostatic hyperplasia can not only increase success rate of one- time catheterizations,but also reduce damage to urethral mucosa and alleviate pain and discomfort for patients,which is worthy of clinical promotion.