摘要
目的系统评价子宫切除术后立即拔除导尿管的可行性。方法检索The Cochrane Library、CBM、PubMed、CINAHL、Medline、Embase、Web of Science、中国知网、万方数据知识服务平台、维普中文科技期刊数据库中关于子宫切除术后立即拔除导尿管的临床研究,检索时限为建库至2024年2月1日。两名经过循证护理系统培训的研究者按照纳入与排除标准,对文献进行严格筛选和质量评价后提取相关数据。运用RevMan 5.3软件进行数据分析。结果经过筛选后,共纳入8篇文献,总样本量为1199例。Meta分析结果显示,术后立即拔除导尿管患者尿路感染[RR=0.38,95%CI(0.22,0.65),P<0.001]、首次下床活动时间[SMD=-2.71,95%CI(-3.96,-1.47),P<0.001]和住院时间[SMD=-1.19,95%CI(-2.13,-0.26),P=0.010]均优于延迟拔除导尿管组;术后重新留置导尿管[RR=6.44,95%CI(3.21,12.90),P<0.001]高于延迟拔除导尿管组。结论子宫切除术后立即拔除导尿管可降低患者术后尿路感染的风险,减少首次下床活动和住院的时间,不会增加术后发热的风险,但重新留置导尿管的风险显著增加。
Objective To systematically evaluate the feasibility of immediate removing of bladder catheter after hysterectomy.Methods The Cochrane Library,CBM,PubMed,CINAHL,Medline,Embase,Web of Science,CNKI,Wanfang Data and VIP were searched for clinical studies on the removal of catheters immediately after hysterectomy.The retrieval time limit was from the establishment of the data⁃base to February 1,2024.Two researchers trained by evidence-based nursing system extracted relevant data after strict screening and quality evaluation of the literature according to the integration and exclusion criteria.Data analysis was performed using RevMan 5.3 software.Results After screening,a total of 8 articles were included that with a total sample quantity of 1199 cases.The Meta analysis showed that the urinary tract infection[RR=0.38,95%CI(0.22,0.65),P<0.001],first ambulation time[SMD=-2.71,95%CI(-3.96,-1.47),P<0.001]and hospitalization time[SMD=-1.19,95%CI(-2.13,-0.26),P=0.010]in patients with immediate removal of urinary catheter were better than those in patients with delayed removal of urinary catheter.Re-indwelling catheter after operation[RR=6.44,95%CI(3.21,12.90),P<0.001]was higher than that in delayed removal group.Conclusion After hysterectomy urethral catheter removal immediately can reduce the risk of urinary tract infection,shorten the time of first ambulation and hospitalization,and it does not increase the risk of postoperative fe⁃ver,but the risk of catheter replacement is significantly increased.
作者
胡浩然
纪彩卿
冯会玲
耿伯雅
田娜
HU Haoran;JI Caiqing;FENG Huiling;GENG Boya;TIAN Na(School of Nursing,Hebei University of Traditional Chinese Medicine,Shijiazhuang 050091,China;Nursing Department,Hebei Provincial People's Hospital,Shijiazhuang 050051,China;Department of Gynecology,Hebei Provincial People's Hospital,Shijiazhuang 050051,China)
出处
《护理管理杂志》
CSCD
2024年第5期449-454,共6页
Journal of Nursing Administration
基金
河北中医药大学2023年研究生创新资助立项项目(XCXZZSS2023039)。
