文献类型：期刊文献

中文题名：不同导尿方式在神经源性膀胱病人中应用效果的网状Meta分析

英文题名：Application effect of different catheterize ways in patients with neurogenic bladder:a network Meta?analysis

作者：牛明明[1,2];高亚[1];闫美丽[1,2];张丽[3];张艳[4];于慧金[4];杨小霞[4];孙军弟[4];田金徽[1,5]

第一作者：牛明明

机构：[1]兰州大学循证医学中心/兰州大学基础医学院,甘肃730000;[2]兰州大学循证护理中心/兰州大学护理学院;[3]甘肃中医药大学附属医院;[4]甘肃省康复中心医院;[5]甘肃省循证医学与临床转化重点实验室

第一机构：兰州大学循证医学中心/兰州大学基础医学院,甘肃730000

年份：2022

卷号：36

期号：22

起止页码：3968

中文期刊名：护理研究

外文期刊名：Chinese Nursing Research

收录：CSTPCD;;北大核心:【北大核心2020】；

基金：兰州市人才创新创业项目,编号:2020?RC?63。

语种：中文

中文关键词：神经源性膀胱;无菌间歇导尿;清洁间歇导尿;无接触式间歇导尿;留置导尿;随机对照试验;网状Meta分析;护理

外文关键词：neurogenic bladder;sterile intermittent catheterization;clean intermittent catheterization;non-contact intermittent catheterization;indwelling catheterization;randomized controlled trial;network Meta?analysis;nursing

摘要：目的:使用网状Meta分析比较不同导尿方式在神经源性膀胱病人中的应用效果。方法:系统检索PubMed、Cochrane Library、EMbase、Web of Science、中国生物医学文献数据库、万方数据库、中国知网、维普资讯网等中英文数据库以及北美临床试验注册中心、世界卫生组织国际临床试验注册平台、中国临床试验注册中心等临床试验注册平台中有关不同导尿方式在神经源性膀胱病人中应用效果的随机对照试验,检索时限为从建库到2021年9月30日。由2名研究者独立筛选文献、提取资料并评估偏倚风险后,采用Stata 15和RStudio软件进行网状Meta分析。结果:共纳入29项随机对照试验,网状Meta分析结果显示,与留置导尿相比,无菌间歇导尿[OR=0.13,95%CI(0.08,0.21)]、清洁间歇导尿[OR=0.17,95%CI(0.12,0.24)]、无接触式间歇导尿[OR=0.13,95%CI(0.05,0.36)]均能降低尿路感染发生率;清洁间歇导尿能够有效降低尿路结石发生率[OR=0.11,95%CI(0.03,0.39)];无菌间歇导尿[MD=-105.16,95%CI(-130.60,-79.72)]、清洁间歇导尿[MD=-77.61,95%CI(-98.83,-56.39)]均能减少残余尿量;无菌间歇导尿[MD=70.65,95%CI(5.04,136.27)]、清洁间歇导尿[MD=81.58,95%CI(29.33,133.82)]均能改善病人膀胱容量;无菌间歇导尿[MD=12.00,95%CI(6.81,17.20)]、清洁间歇导尿[MD=11.14,95%CI(7.94,14.34)]均能促进病人膀胱压力恢复。结论:当前证据表明,无菌间歇导尿与清洁间歇导尿在减少并发症发生、促进膀胱功能恢复方面效果较佳。但受文献质量和数量影响,还需要更多高质量、大样本研究予以验证。
Objective:To compare application effect of different catheterize ways in patients with neurogenic bladder by using network Meta?analysis.Methods:Randomized controlled trials on application effect of different catheterize ways in patients with neurogenic bladder were retrieved from PubMed,Cochrane library,EMbase,Web of Science,CBM,Wanfang database,CNKI,VIP and other Chinese and English databases,as well as the Clinical trial registration platform such as North American Clinical Trial Registration Center,the World Health Organization International Clinical Trials Registry Platform,Chinese Clinical Trial Registry and so on.And retrieval time was from database establishment to September 30,2021.Two researchers independently screened the literature,extracted data and assessed the risk of bias,then network Meta?analysis was performed by Stata 15 and RStudio software.Results:A total of 29 randomized controlled trials were included.The network Meta-analysis showed that compared with indwelling catheterization,sterile intermittent catheterization[OR=0.13,95%CI(0.08,0.21)],clean intermittent catheterization[OR=0.17,95%CI(0.12,0.24)]and non?contact intermittent catheterization[OR=0.13,95%CI(0.05,0.36)]could reduce incidence of urinary tract infection.Compared with indwelling catheterization,clean intermittent catheterization could effectively reduce incidence of urinary calculi[OR=0.11,95%CI(0.03,0.39)].Compared with indwelling catheterization,sterile intermittent catheterization[MD=-105.16,95%CI(-130.60,-79.72)]and clean intermittent catheterization could reduce residual urine volume[MD=-77.61,95%CI(-98.83,-56.39)].Compared with indwelling catheterization,sterile intermittent catheterization[MD=70.65,95%CI(5.04,136.27)]and clean intermittent catheterization[MD=81.58,95%CI(29.33,133.82)]could improve bladder capacity of patients.Compared with indwelling catheterization,sterile intermittent catheterization[MD=12.00,95%CI(6.81,17.20)]and clean intermittent catheterization[MD=11.14,95%CI(7.94,14.34)]could promote bladder pressure recovery of patients.Conclusions:The current evidence shows that sterile intermittent catheterization and clean intermittent catheterization have better effects in reducing complications and promoting recovery of bladder function.However,depending on the quality and quantity of the literature,more high?quality and large sample studies are needed to verify.