延长置管深度对老年患者清洁灌肠次数、灌肠液保留时间及灌肠效果的Meta分析

Effect of prolonged catheterization on the number of cleansing enema, enema retention time and enema outcome in elderly patients: A Meta-analysis

目的系统评价延长置管深度对老年患者清洁灌肠结局的影响。方法网络检索中国知网(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(China Biology Medicinedisc,CBM)、万方数据知识服务平台(Wanfang Data)、维普数据库(VIP database,VIP)、PubMed、荷兰医学文摘数据库(Excerpta Medical Database,Embase)、CINAHL(The Cumulative Index to Nursing & Allied Health Literature,CINAHL)数据库,搜集关于延长置管深度在老年患者清洁灌肠结局的随机对照研究,检索时间为建库至2018年1月1日。语种为中文和英文,由两名研究者独立筛选文献,提取数据,评价纳入研究的偏倚风险后,运用Revman 5.3软件进行Meta分析。结果共纳入7篇随机对照研究,共521例患者。Meta分析结果显示:延长置管深度在老年患者清洁灌肠次数[ MD =-3.99,95% CI (-6.86,-1.12), P <0.01 ]、灌肠液保留时间[ OR =12.94,95% CI (7.25,23.09), P <0.01 ]和灌肠效果[ OR =12.36,95% CI (7.30,20.92), P <0.01 ]均优于传统置管深度( 7~ 10 cm )。结论延长置管深度在老年患者清洁灌肠中,可减少灌肠次数、延长灌肠液保留时间和提高患者清洁灌肠效果。受纳入研究发表年限和质量的限制,研究结果有待进一步高质量研究验证。

Objective To evaluate the effect of prolonged catheterization on the outcome of cleansing enema in elderly patients by systematic review. Methods The literatures on randomized controlled trials of catheterization depth in elderly patients with cleansing enema were searched from China National Knowledge Infrastructure (CNKI), China Biology Medicinedisc (CBM),Wanfang Data, VIP Database (VIP), PubMed , Excerpta Medical Database (Embase), The Cumulative Index to Nursing &Allied Health Literature (CINAHL) database since January 1st 2018. The data and risk of bias were assessed by two reviewers independently. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 7 randomized controlled trials included with 521 patients being included. Meta-analysis results showed that the length of catheterization was increased in elderly patients with cleansing enema, number of times ( MD =-3.99, 95% CI [-6.86,-1.12], P <0.01 ), enema retention time ( OR =12.94, 95% CI [7.25, 23.09], P <0.01 ) and enema effect ( OR =12.36, 95% CI [7.30, 20.92], P <0.01 ) were superior to conventional catheterization depth ( 7-10 cm). Conclusions Extending the depth of catheterization in elderly patients with cleansing enema can reduce the number of enema, prolong the retention time, and improve the outcome of cleansing enema. Due to the limitations of the publication year and quality of the study, more high quality studies are required to verify above conclusions.