间歇导尿在宫颈癌根治术后患者应用效果的meta分析

Meta-analysis of the Effect of Intermittent Catheterization in Patients after Radical Resection of Cervical Cancer

目的分析间歇导尿对宫颈癌根治术后患者尿液引流的应用效果。方法在the Cochrane Central Register of Controlled Trials、MEDLINE、EMBASE、Web of Science、Clinical Trials.gov、EBSCO、中国生物医学文献数据库、中国知网全文数据库、中国科技期刊维普数据库和万方数据库中检索关于间歇导尿与经尿道留置导尿的随机对照试验。由两名研究人员根据事先共同设定的标准进行文献筛选、资料提取以及文献质量评价。采用Review Manager 5.3进行数据整合分析。结果初检出518篇,最终纳入10篇文献,累计研究实验对象1033例,其中干预组519例、对照组514例。Meta分析结果显示,两组泌尿系统感染发生例数[OR=0.10,95%CI为(0.07,0.14),P<0.001)、膀胱功能恢复例数[OR=6.94,95%CI为(4.70,10.26),P<0.001)、残余尿量[MD=-81.48,95%CI为(-107.68,-55.28),P<0.001)、带管时间[SMD=-1.24,95%CI为(-1.48,-1),P<0.001)差异有统计学意义。结论间歇导尿在宫颈癌根治术后患者尿液引流中的泌尿系统感染发生率、膀胱功能恢复等方面均优于经尿道留置导尿。

Objective To analyze the effect of intermittent catheterization on urine drainage in patients after radical resection of cervical cancer.Methods Search randomized controlled trials regarding intermittent catheterization and transurethral indwelling catheterization in the Cochrane Central Register of Controlled Trials,MEDLINE,EMBASE,Web of Science,Clinical Trials.gov,EBSCO,China Biomedical Literature Database,China Knowledge Network Full-text Database,Chinese Science and Technology Journal VIP Database and Wanfang Database.Literature screening,data extraction,and literature quality evaluation were performed by two researchers based on previously established criteria.Data integration analysis was completed through Review Manager 5.3.Results 518 articles were initially detected,and 10 articles were finally included.A total of 1033 subjects were enrolled,including 519 patients in the intervention group and 514 patients in the control group.Meta-analysis showed that differences about the number of urinary tract infections[OR=0.10,95%CI(0.07,0.14),P<0.001),cases of recovery of bladder function[OR=6.94,95%CI(4.70,10.26),P<0.001),residual urine volume[MD=-81.48,95%CI(-107.68,-55.28),P<0.001),and tube time[SMD=-1.24,95%CI(-1.48),-1),P<0.001)occurred in the two groups were statistically significant.Conclusion Intermittent catheterization is superior to transurethral indwelling catheterization in the incidence of urinary tract infection and recovery of bladder function in patients with urinary drainage after radical resection of cervical cancer.