洗必泰擦浴对预防成人重症监护病房病人导管相关性尿路感染效果的系统评价

Systemic evaluation on efficacy of chlorhexidine sponge bath for preventing catheter-associated urinary tract infections for adult patients in intensive care unit

[目的]评价每日洗必泰（氯己定）擦浴预防成人重症监护病房病人导管相关性尿路感染发生的效果。[方法]通过系统检索PUBMED,EMBASE,Cochrane Library以及中国知网（CNKI）数据库,检索时间从建库到2015年3月,两名评价者独立地评价符合标准的随机临床研究和类实验研究并提取所需数据,使用Review Manager 5.3对提取到的数据进行分析。[结果]共计7篇文献纳入研究,包含2篇随机临床试验和5篇类实验研究。试验组应用洗必泰每日擦浴,共观察39 136例病人,共出现471例次导管相关性尿路感染,对照组共观察43 689例病人,共出现804例次导管相关性尿路感染,两组间导管相关性尿路感染发生率差异具有统计学意义（RR为0.68,95%CI为0.52~0.88,P=0.004）。[结论]每日洗必泰擦浴可以明显降低重症监护病房成年病人发生导管相关性尿路感染的风险,但该结论仍需更高质量的临床试验来进一步验证。

Objective：To evaluate the effect of daily chlorhexidine sponge bath for preventing catheter associat-ed urinary tract infections（CAUTI）in adult patients in the intensive care unit（ICU）.Methods：Systematically searched PUBMED,EMBASE,the Cochrane Library and China National Knowledge Infrastructure（CNKI）from their inception to March 2015.Two reviewers independently evaluated and extracted data from included standard randomized clinical studies and experimental studies.Review Manager 5 .3 was applied to extract data for analy-sis.Results：Total of 7 papers were included in the study,including 2 randomized clinical trials and 5 experimen-tal studies.The result revealed that 471 infections were detected in a total of 39 136 patients in chlorhexidine sponge bath group.And 804 infections were detected in a total of 43 689 patients in control group.The differ-ence between two groups on CAUTI rate were statistical significant（RR=0.68,95%CI was 0.52 0.88,P=0.004）. Conclusions：Daily chlorhexidine sponge bath can significantly reduce the risk of CAUTI for adult patients in ICU.While the conclusion still needs high quality clinical trials to further verify.