全麻腰椎术后男性患者早期拔除尿管的最佳证据总结

doi:10.16460/j.issn1008-9969.2020.11.046

摘要/Abstract

摘要： 目的评价总结全麻腰椎术后男性患者早期拔除尿管的最佳证据。方法计算机检索留置尿管患者早期拔除相关证据,并从中筛选符合纳入标准的文献。经过循证培训的研究人员对纳入文献进行质量评价和资料提取,对符合质量标准的文献进行证据的归纳总结。结果共纳入文献4篇,指南3篇,证据总结1篇。最佳证据总结如下：（1）尽量缩短患者尿管留置时间（A 级推荐）;（2）选择合适的拔管时机（B 级推荐）;（3）每天评估并记录置管原因（A 级推荐）;（4）在条件允许的情况下,建议使用提醒系统或者停止系统,以便及时拔除尿管（A 级推荐）;（5）做好患者宣教、医护人员培训（B 级推荐）。（6）采取相应措施,促进膀胱功能恢复（B 级推荐）。结论留置导尿管是尿路感染的重要原因之一,医护人员应准确评估尿管拔除时机,尽早拔除不必要尿管,以有效减少尿路感染风险及拔管后不良事件的发生。

关键词: 全麻, 腰椎术后, 男性, 留置导尿, 拔除尿管, 证据总结

Abstract: Objective To evaluate and summarize the best evidence of early removal of urinary catheters in male patients after lumbar spine surgery under general anesthesia. Methods We electronically retrieved the research on early removal of urinary catheter. Two reviewers independently assessed the quality and extracted the data from the included studies and evidence was summarized from eligible studies. Results Four studies were included, with 3 guidelines and 1 best evidence summary. Evidences were summarized in the following:(1)Try to minimize the duration of catheterization (strength of recommendation=A).(2)Select appropriate timing of extubation(strength of recommendation=B).(3)Evaluate and record the reason for catheterization (strength of recommendation=A).(4)When conditions permit, it is recommended to use the reminder system or stop the system in order to remove the catheter in time (strength of recommendation=A).(5)Do a good job in patient education and training of medical personnel (strength of recommendation=B).(6)Take appropriate measures to promote bladder function recovery (Strength of recommendation=B). Conclusion Indwelling catheter is one of the important reasons for urinary tract infection. Medical staff should accurately assess the timing of urinary catheter removal and remove unnecessary urinary catheter as soon as possible to effectively reduce the risk of urinary tract infection and adverse events after extubation.

Key words: general anesthesia, lumbar surgery, male, urinary catheterization, removal of urinary catheter, evidence summary

中图分类号:

R473.6

郭晓宇, 史冬立, 张振美, 李娜, 张佩凤, 杨丽娟. 全麻腰椎术后男性患者早期拔除尿管的最佳证据总结[J]. 护理学报, 2020, 27(11): 46-51.

GUO Xiao-yu, SHI Dong-li, ZHANG Zheng-mei, LI Na, ZHANG Pei-feng, YANG Li-juan. Best Evidence Summary for Early Removal of Urinary Catheters in Male Patients after Lumbar Spine Surgery under General Anethesia[J]. Journal of Nursing, 2020, 27(11): 46-51.

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