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结直肠手术后患者术后尿潴留的风险因素:系统评价和荟萃分析。

Risk factors for postoperative urinary retention in patients undergoing colorectal surgery: a systematic review and meta-analysis.

机构信息

Department of Gastrointestinal Surgery, Affiliated Hospital of Yangzhou University, Yangzhou, China.

School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China.

出版信息

Int J Colorectal Dis. 2022 Dec;37(12):2409-2420. doi: 10.1007/s00384-022-04281-w. Epub 2022 Nov 11.

Abstract

PURPOSE

Postoperative urinary retention (POUR) is a common complication following colorectal surgery. The incidence of POUR among colorectal surgery patients varies widely, and the risk factors and outcomes of POUR are also debatable. This meta-analysis aims to systematically evaluate the risk factors for POUR in patients after colorectal surgery.

METHODS

PubMed, Web of Science, the Cochrane Library, Embase, Medline, and Chinese databases (CBM, CNKI, and WanFang Databases) were searched to identify relevant cohort studies (from inception to August 2022). Two researchers independently conducted literature quality evaluation and data extraction. All data were analyzed by using the Review Manager 5.4 software.

RESULTS

Nineteen studies with 101,025 patients were included in this meta-analysis. The risk factors for POUR in colorectal surgery patients were male sex, older age, diabetes mellitus, urological diseases, tumor location in the lower rectum, APR, laparoscopic surgery, operation time ≥ 4 h, postoperative date of urinary catheter removal, excessive intraoperative intravenous fluid volume, and postoperative ileus. The postoperative anastomotic leak, on the other hand, was not a risk factor for POUR.

CONCLUSIONS

Multiple risk factors influence the incidence of POUR in patients undergoing colorectal surgery. To reduce the incidence of POUR in colorectal surgery patients, medical staff should identify risk factors early and enforce interventions to prevent them.

摘要

目的

术后尿潴留(POUR)是结直肠手术后的一种常见并发症。结直肠手术患者的 POUR 发生率差异很大,其风险因素和结局也存在争议。本荟萃分析旨在系统评估结直肠手术后患者发生 POUR 的风险因素。

方法

检索 PubMed、Web of Science、Cochrane 图书馆、Embase、Medline 和中文数据库(CBM、CNKI 和万方数据库),以确定相关的队列研究(从建库至 2022 年 8 月)。两名研究人员独立进行文献质量评价和数据提取。所有数据均采用 Review Manager 5.4 软件进行分析。

结果

本荟萃分析纳入了 19 项研究,共 101025 例患者。结直肠手术患者发生 POUR 的风险因素包括男性、年龄较大、糖尿病、泌尿系统疾病、直肠下段肿瘤、腹会阴联合切除术、腹腔镜手术、手术时间≥4 h、术后拔除导尿管时间、术中静脉输液量过多、术后肠梗阻。另一方面,术后吻合口漏不是 POUR 的风险因素。

结论

多种风险因素影响结直肠手术患者 POUR 的发生率。为降低结直肠手术患者 POUR 的发生率,医务人员应早期识别风险因素并采取干预措施予以预防。

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