ヒップ骨折の高齢患者における手術後の尿収縮の発生率と危険因子: スコーピングレビュー
Jinghua Xia1, Dan Zhao1, Yanzhen Hu1
1Department of Nursing, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
BMJ open
|September 5, 2025
まとめ
高齢の股関節骨折患者における術後の尿収縮 (POUR) は,日常生活の障害,薬剤,合併症を含むリスク要因によって大きく異なります. これらの発見を確認するには,さらなる研究が必要である.
科学分野:
- 高齢者医療
- 整形 術
- 泌尿器科
背景:
- 術後の尿収縮 (POUR) は,股関節骨折手術後の高齢者の一般的な合併症です.
- POURの流行とリスク要因を理解することは,患者のケアと結果を最適化するために不可欠です.
研究 の 目的:
- 骨折した高齢者のPOURの有病率と影響要因に関する証拠を統合するスコーピングレビューを実施する.
- この特定の患者集団におけるPOURに関連する主要な危険因子を特定する.
主な方法:
- 2024年9月1日までの複数のデータベース (PubMed,Cochrane,CINAHL,Web of Science,CNKI,Wanfang,Sinomed) の系統的な検索
- 60歳以上の患者でPOURの流行とリスク要因を報告した観察研究を含める.
- レビュー,定性研究,ケーススタディ,英語や中国語以外の言語での研究を除外します.
主要な成果:
- 12件の研究が含まれており,高齢の股関節骨折患者のPOUR発生率は11. 10%から51. 33%であった.
- 特定された危険因子には,日常生活における活動障害,抗コレリン薬/オピオイド薬,特定の血清学的指標,尿道感染症,失禁,長時間カテーテル使用,および便不全が含まれます.
- 男性性,認知障害,糖尿病などの潜在的な危険因子については,さらなる調査が必要です.
結論:
- 高齢の股関節骨折患者におけるPOURの発生率は,著しく変動しています.
- 報告された多くの危険因子には 確立された基礎的なメカニズムが欠けていて 質の高いさらなる研究によって 検証が必要である.
- 将来の研究では,これらのリスク要因を確認し,POURの臨床管理を改善するためのメカニズムを明らかにすることに重点を置くべきです.
関連する概念動画
01:21Nursing Assessment of the Genitourinary System I: Health History
75
The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
75
01:28Urinary Tract Calculi V: Nursing Management
27
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
27
01:26Nursing Assessment of the Genitourinary System II: Inspection and Palpation
221
The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
221
01:25Urinary Tract Calculi VI: Surgical Management
25
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
25
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
29
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
29
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
39
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
39