术前导尿对减少人工全膝关节置换术患者术后尿路感染效果的Meta分析

The prevention effect of urinary catheterization on urinary tract infection in patient with total knee replacement: a meta-analysis

目的:评价不留置尿管或术前不实施导尿术对人工全膝关节置换术患者术后患者泌尿系统并发症发生率的影响。方法:通过Embase、Medline、Pubmed、Elsevier、CBMdisc、CNKI、Cochrane library、Joanna Briggs(JBI)循证卫生保健国际合作中心图书馆等数据库检索关于术前留置尿管和不留置尿管对人工全膝关节置换术患者的临床对照试验。采用Cocahrane Handbook 4.2.2对文献质量进行评价,RevMan 5.3.0对文献资料进行Meta分析。结果:共纳入7项文献,其中6项RCT和1项CCT。5项研究结果显示不留置尿管可以降低尿路感染的发生率,4项研究结果显示不留置尿管可增加术后尿潴留的发生率。结论:术前不留置尿管可以降低人工全膝关节置换术后患者尿路感染的发生率。

Objective: To systematically evaluate the prevention effect of no urinary catheterization on urinary tract infection in patient with total knee replacement. Methods: We searched Embase、Medline、Pubmed、Elsevier、CBMdisc、CNKI、Cochrane library、Joanna Briggs(JBI) to collect clinical controlled trials( RCTs and CCTs).Cochrane Handbook version 4.2.2 was used to assess trial quality by two review authors independently.Meta analysis was conducted for the eligible RCTs using RevMan 5.3.0. Results: 6 RCTs and 1 CCT were included. 5 studies indicated that no indwelling catheter decreased the incidences of urinary tract infection. However, 4 studies indicated that no indwelling catheter increased the incidences of urinary retention. Conclusion: No indwelling catheter decreased the incidences of urinary tract infection in patient with total knee replacement.