目的:导尿是产后尿潴留(PUR)的常用治疗方法;其在PUR诊断前的应用尚不清楚。目的是概述有关产时或产后导尿预防PUR的有效性和安全性的现有文献。
方法:本范围审查遵循一个方法论框架。PubMed,Cochrane图书馆,Embase,WebofScience,中国国家知识基础设施,万方,中国科技期刊数据库,从每个数据库开始到2023年5月21日,检索了中国生物医学文献数据库。
结果:搜索显示16项研究检查了三种不同的导管插入方法,包括12项产时研究。十项研究得出结论,产时或产后导管插入术可预防PUR,其中两个仅用于公开或秘密PUR。13项实验研究中有4项,没有发现显着差异:一个用于产时导管插入术与常规护理,另一种用于产时或产后间歇性与留置导尿。然而,一项研究发现,与留置导尿相比,无效针对性护理后的产后一次性导尿降低了PUR的发生率.3项病例对照研究中的一项得出结论,产前导管插入≥2次是PUR的危险因素。
结论:根据本范围审查的结果,在诊断PUR之前进行导管检查似乎在预防PUR中起作用并且是安全的.初步证据表明,三种导管插入方法在预防PUR方面的有效性正在积累,但是需要更全面的研究来确定这些发现。
OBJECTIVE: Catheterization is a common treatment for postpartum urinary retention (PUR); however, its application before diagnosis of PUR remains unclear. The aim was to give an overview of the existing literature on the effectiveness and safety of intrapartum or postpartum catheterization in the prevention of PUR.
METHODS: This scoping
review followed a methodological framework. PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, WanFang, the China Science and Technology Journal Database, and the China Biomedical Literature Database were searched from the inception of each database to 21 May 2023.
RESULTS: The search revealed 16 studies examining three different catheterization methodologies, including 12 intrapartum studies. Ten studies concluded that intrapartum or postpartum
catheterization prevented PUR, two of which were only for overt or covert PUR. In 4 out of 13 experimental studies, no significant difference was found: one for intrapartum catheterization versus routine nursing, the other for intrapartum or postpartum intermittent versus indwelling catheterization. However, one found that postpartum disposable catheterization after ineffective targeted care reduced the incidence of PUR compared with indwelling
catheterization. One out of the 3 case-control studies concluded that prenatal catheterization ≥2 times was a risk factor for PUR.
CONCLUSIONS: Based on the findings in this scoping
review,
catheterization prior to the diagnosis of PUR appears to play a role in preventing PUR and is safe. Preliminary evidence is accumulating on the effectiveness of three types of catheterization methods in preventing PUR, but more comprehensive studies are needed to establish these findings.