探討合併藥物治療對雙J導管置入病人疼痛及泌尿症狀之成效－系統性文獻回顧

Efficacy of Combined Medicine Treatment for Pain and Urinary Symptoms in Patients with Ureteral Double-J Catheters: A Systematic Review

蘇淑芬(Shu-Fen Su) ； 吳孟珊(Meng-Shan Wu) ； 張君伃(Jyun-Yu Jhang)

《榮總護理》 36卷3期 (2019/09) Pp. 297-308

https://doi.org/10.6142/VGHN.201909_36(3).0009

摘要

輸尿管雙J導管作用在引流尿液至膀胱，以保持輸尿管順暢，但雙J導管容易引起疼痛、血尿或泌尿道症狀。臨床上常用藥物有Solifenacin與Tamsulosin，症狀控制的效果卻不一致。本系統性文獻回顧為探討合併藥物治療對雙J導管置入病人疼痛及泌尿症狀之效果，以提供用藥及照護措施之建議。本文運用PubMed、CINAHL、Cochran Library、Medline、Google Scholar、華藝線上圖書館、台灣碩博士論文資料庫，以關鍵字，P：輸尿管雙J導管置入病人（patient with ureteral double-J cathter），I：合併Tamsulosin和Solifenacin藥物治療（combined Tamsulosin and Solifenacin），C：常規照護（routine care），O：疼痛（pain）和泌尿症狀（urinary symptoms）。搜尋2009-2019年中、英文獻，選取與主題相關之7篇隨機（類）實驗研究及1篇案例對照研究，以CASP為文章品質評析工具。因研究對象、用藥劑量、症狀評估工具及追蹤時間不一致，無法比較8篇研究的結果，僅以系統性文獻回顧提出併用Solifenacin及Tamsulosin藥物治療與單一用藥緩解雙J導管置入引起疼痛及泌尿症狀的初步效果。未來宜再進行觀察性研究，追蹤藥物治療與雙J導管引起的症狀及效果，作為藥物治療的修正方向。

關鍵字

輸尿管雙J導管置入 ； 合併藥物治療 ； 疼痛 ； 泌尿症狀

並列摘要

The ureteral double-J catheter was developed to drain urine from the kidney to the urinary bladder, but it can lead to bodily pain, hematuria, and urinary symptoms. Despite being the two most common therapeutic medications for complications associated with the double-J catheter, solifenacin and tamsulosin have inconsistent effectiveness. This systematic review aimed to investigate the efficacy of combined medicine treatment for pain and urinary symptoms in patients with ureteral double-J catheters. Electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, Google Scholar, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan, were searched using the following keywords in the PICO format: P, patient with the ureteral double-J catheter; I, combined tamsulosin and solifenacin; C, routine care; and O, pain and urinary symptoms. Inclusion criteria included studies published in Chinese and English from 2009 to 2019 and experimental, quasi-experimental, and case-control studies. The Critical Appraisal Skills Programme (CASP) was used to appraise the quality of reviewed studies. It was difficult to compare the clinical results of studies in terms of therapeutic doses, symptom assessment tools, and follow-up period. However, we obtained preliminary results regarding comparison of the combination and monotherapy in improving pain and urinary symptoms related to double-J catheter placement. Large-scale, observational studies are necessary to clarify the most effective medication for relieving pain and urinary symptoms associated with the double-J catheter.

並列關鍵字

ureteral double-J catheters ； combined medicine treatment ； pain ； urinary symptoms

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