Callan Laurie, Thompson Donna L, Netsch Debra
Laurie Callan, MSN, APRN, FNP-BC, CWOCN, NP Services, LLC, Clinton, Iowa. Donna L. Thompson, MSN, CRNP, FNP-BC, CCCN-AP, University of Pennsylvania, Division of Urogynecology, Philadelphia. Debra Netsch, DNP, APRN, FNP-BC, CWOCN, Ridgeview Medical Center & webWOC Nurse Education Program; Minneapolis, Minnesota.
J Wound Ostomy Continence Nurs. 2015 Nov-Dec;42(6):614-20. doi: 10.1097/WON.0000000000000183.
Modifying fluid intake to decrease overactive bladder (OAB) symptoms, urgency, frequency, and urge urinary incontinence is advocated by health care professionals.
This Evidence Based Report Card reviews whether increasing or decreasing the daily intake of water and/or fluids by adults decreases their OAB symptoms.
Three reviewers systematically reviewed the literature for studies that evaluated the association or effect of fluid intake on OAB urinary symptoms in adult men and women. A professional librarian performed the literature search, which yielded 260 articles. Following title and abstract reviews, 48 articles were identified for full-text review, and of these, 10 articles met the criteria for inclusion in this review.
Results of studies measuring the effect of fluid intake on the severity of OAB symptoms support that reducing fluid intake is beneficial in reducing OAB symptoms of urge UI, urgency, and frequency. There is evidence that increasing fluid by 25% to 50% could increase daytime frequency; however, studies did not show a significant effect on urgency. Increasing fluid intake is associated with worsening of OAB symptoms in observational studies and shows no difference in symptoms compared to controls in interventional studies.
WOC nurses should recommend decreased fluid intake for managing OAB symptoms, while ensuring adequate hydration for other health needs (Strength of Recommendations for Treatment statement level 1).
医疗保健专业人员提倡调整液体摄入量以减轻膀胱过度活动症（OAB）症状、尿急、尿频和急迫性尿失禁。
本循证报告卡评估成年人增加或减少水和/或液体的每日摄入量是否能减轻其OAB症状。
三名评审员系统地检索文献，查找评估液体摄入量与成年男性和女性OAB泌尿系统症状之间关联或影响的研究。一名专业图书馆员进行了文献检索，共检索到260篇文章。经过标题和摘要评审后，确定了48篇文章进行全文评审，其中10篇文章符合纳入本综述的标准。
测量液体摄入量对OAB症状严重程度影响的研究结果支持减少液体摄入量有助于减轻尿急性尿失禁、尿急和尿频等OAB症状。有证据表明，液体摄入量增加25%至50%可能会增加白天的排尿频率；然而，研究并未显示对尿急有显著影响。在观察性研究中，增加液体摄入量与OAB症状恶化有关，而在干预性研究中，与对照组相比，症状没有差异。
造口、伤口及失禁护理护士应建议减少液体摄入量以管理OAB症状，同时确保满足其他健康需求的充足水合作用（治疗建议声明级别为1级）。
