剖宫产术后导尿管留置时间的Meta分析

Meta-analysis of postoperative indwelling time of urinary catheter after cesarean section

目的探讨剖宫产术后留置导尿管不同时间对产妇排尿情况的影响。方法计算机检索Pubmed、Cochrane Library、Medline、中国学术期刊全文数据库CNKI、中国生物医学文献服务系统SinoMed、万方数据库资源系统和维普中文期刊全文数据库VIP,检索时限为自数据库建库至2017年5月,查找比较剖宫产术后留置导尿管的不同时间对产妇排尿情况影响的随机对照试验文献,并对符合纳入标准的文献进行质量评价及有效数据的提取,进行Meta分析。纳入7篇文献,共1 323例研究对象。结果在剖宫产术后,立即拔除导尿管与术后常规留置12～24 h导尿管比较,尿潴留发生率差异无统计学意义,但尿路感染率明显降低。手术后留置导尿管6～8 h与12～24 h比较,尿潴留发生率及尿路感染率均明显降低。结论剖宫产术后留置导尿管最佳时长为6～8 h。

Objective To compare the influences of indwelling urinary catheter removal at different time after cesarean section. Methods Randomized controlled trials (RCTs) of indwelling urinary catheter removal at different time were collected in databases including Pubmed, Cochrane Library, Medline, CNKI, SinoMed, Wanfang database, VIP, etc. The selected literatures were evaluated and the effective data were extracted. Data were analyzed by RevMan 5.3 version software. Seven RCTs were included, and 1 323 subjects were studied. Results After cesarean sections, there was no significant difference in urinary retention between indwelling for 12-24 h group and immediate removal of urinary catheter group. But the rate of urinary tract infection was decreased in immediate removal of urinary catheter group. Compared with indwelling for 12-24 h group, indwelling for 6-8 h group had lower rates of urinary retention and urinary tract infection. Conclusion The best postoperative indwelling time is 6-8 h after cesarean section.