间歇性导尿预防神经源性膀胱患者泌尿系感染的meta分析

目的评价间歇性导尿预防神经源性膀胱患者发生泌尿系感染的效果。方法计算机检索PubMed、Embase、中国知网、万方数据库、维普数据库2018年1月-2019年4月的相关文献,纳入间歇导尿用于预防神经源性膀胱患者发生泌尿系感染的随机对照研究,由2名研究者按照检索公式独立筛选文献、提取数据、评价纳入文献的方法学质量,使用RevMan5.3对收集的数据进行统计分析。结果共纳入7篇文献,包括737例患者,分析结果显示:间歇性导尿组患者在膀胱功能恢复方面和尿残余量两方面均优于常规留置导尿组,间歇性导尿组患者的泌尿系感染率低于常规留置导尿组[RR=0.31,95%CI(0.24,0.40),P<0.01],差异存在统计学意义。结论间歇导尿与常规留置导尿相比能降低患者泌尿系感染的发生率,但是纳入研究的仅为中文文献,仍需开展高质量多中心的RCT研究予以验证。

Meta-analysis of effect of intermittent catheterization on prevention of urinary tract infection in patients with neurogenic bladder

OBJECTIVE To evaluate the effect of intermittent catheterization in preventing urinary tract infection in patients with neurogenic bladder.METHODS From Jan 2018 to Apr 2019,independently the relevant literatures,PubMed,Embase,China National Knowledge Infrastructure(CNKI),Wanfang database and Chinese Medical Journal database were searched using key words.The literatures were included in the randomized controlled study of intermittent urinary catheterization for the prevention of urinary tract infection in patients with neurogenic bladder.Two researchers independently screened the literatures,extracted data and evaluated the methodological quality of the literatures included according to the retrieval formula.The collected data was analyzed by using RevMan 5.3.RESULTS A total of 7 literatures were included,including 737 patients.The results showed that the intermittent catheterization group was superior to the routine indwelling catheterization group in bladder function recovery and urinary residual volume;the infection rate of urinary system in the intermittent catheterization group was significantly lower than that in the routine indwelling catheterization group[RR=0.31,95%CI(0.24,0.40),P<0.01].CONCLUSION Intermittent catheterization can reduce the incidence of urinary system infection in patients compared with conventional indwelling catheterization,but only Chinese literature has been included in the study,which still needs to be verified by high-quality multi-center RCT study.