McPhail M J W, Abu-Hilal M, Johnson C D
University Surgical Unit, Mail Point 816, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Br J Surg. 2006 Sep;93(9):1038-44. doi: 10.1002/bjs.5424.
Although bladder drainage is widely used for general surgical patients undergoing laparotomy, there is little consensus on whether suprapubic or transurethral catheterization is better.
A systematic database search was undertaken to find all studies of suprapubic catheterization. Randomized controlled trials were identified for inclusion. Endpoints for analysis were bacteriuria, patient satisfaction and recatheterization rates. A meta-analysis was performed using fixed-effect or random-effect models as appropriate, depending on heterogeneity.
After abdominal surgery, transurethral catheterization is associated with significant bacteriuria (relative risk (RR)=2.02, P<0.001, 95 percent confidence interval (c.i.) 1.34 to 3.04) and pain or discomfort (RR=2.94, P=0.004, 95 percent c.i. 1.41 to 6.14). Recatheterization rates using the transurethral method were not increased significantly (RR=1.97, P=0.213, 95 percent c.i. 0.68 to 5.74) with heterogeneity between studies.
The suprapubic route for bladder drainage in general surgery is more acceptable to patients and reduces microbiological morbidity.
尽管膀胱引流广泛应用于接受剖腹手术的普通外科患者，但对于耻骨上导尿术和经尿道导尿术哪种更好，几乎没有共识。
进行系统的数据库检索以查找所有关于耻骨上导尿术的研究。确定纳入随机对照试验。分析的终点指标为菌尿症、患者满意度和再次导尿率。根据异质性情况，酌情使用固定效应或随机效应模型进行荟萃分析。
腹部手术后，经尿道导尿术与显著的菌尿症（相对危险度（RR）=2.02，P<0.001，95%置信区间（c.i.）1.34至3.04）以及疼痛或不适（RR=2.94，P=0.004，95% c.i. 1.41至6.14）相关。经尿道导尿术的再次导尿率没有显著增加（RR=1.97，P=0.213，95% c.i. 0.68至5.74），各研究之间存在异质性。
普通外科中耻骨上膀胱引流途径更易为患者接受，并可降低微生物感染的发病率。
