神经源性膀胱患者留置尿管拔除管理的最佳证据总结

Summary of the best evidence for the management of indwelling catheter removal in patients with neurogenic bladder

目的评价并总结神经源性膀胱患者留置尿管拔除管理的最佳证据,为临床实践提供循证参考依据。方法检索BMJ、UpToDate、Cochrane Library、JBI、PubMed、Embase、欧洲泌尿外科协会网站(EAU)、中国知网、万方数据知识服务平台等的所有二次研究,检索时限为建库至2024年3月1日,并由2名研究者独立进行文献质量评价和证据提取。结果最终纳入11篇文献,其中6篇临床指南、1篇专家共识、3篇系统评价、1篇证据总结,提取了尿管拔管前评估、拔管中处理、拔管后管理、健康教育与随访4个方面21条最佳证据。结论该研究总结了神经源性膀胱患者尿管管理的最佳证据,为降低患者泌尿系感染的发生率,促进患者膀胱功能恢复提供依据。

Objective To evaluate and summarize the best evidence for the management of indwelling catheter removal in patients with neurogenic bladder,so as to provide evidence-based references for clinical practice.Methods Studies on the management of indwelling catheter removal in patients with neurogenic bladder were searched in databases including BMJ,UpToDate,Cochrane Library,JBI,PubMed,Embase,the international association of urinary control site,the European association of urology,China national knowledge infrastructure and Wanfang,with search time set from the establishment of databases till March 1st,2024.Then,literature evaluation and evidence extraction were conducted by two researchers.Results A total of 11 articles were screened out,including 6 clinical guidelines,1 expert consensus,3 systematic reviews,1 evidence summary.Finally,21 pieces of best evidence were extracted from 4 aspects,including pre-extubation assessment,intra-extubation treatment,post-extubation management,health education and follow-up.Conclusion This study summarizes the best evidence for urethral management in patients with neurogenic bladder,and provides a basis for reducing the incidence of urinary tract infections and promoting the recovery of bladder function in patients.