我们能否定义间歇性导管治疗应推的最佳后空残留体积,还有其他可以指导间歇性导管治疗方案的措施吗:ICI-RS 2023
Sachin Malde1, Mo Belal2, Rayan Mohamed-Ahmed3
1Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Neurourology and urodynamics
|October 31, 2023
概括
排尿后残留 (PVR) 尿量缺乏明显的高水平值,并且与尿路感染 (UTI) 等并发症没有可靠的联系. 替代措施可以更好地指导干净间歇性自导管 (CISC) 治疗决策.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床实践指南 临床实践指南
背景情况:
- 排泄后残留 (PVR) 尿量是启动干净间歇性自导管 (CISC) 等治疗的常见临床指标.
- 升高的PVR通常被认为会导致诸如反复性尿路感染 (UTI) 和功能衰竭等并发症,尽管证据有限.
- 优化患者护理可能包括识别PVR以外的替代措施,以指导治疗决策.
研究的目的:
- 确定是否存在一个最佳的PVR值来推CISC.
- 探索可以指导CISC协议的替代措施.
- 批判性地评估PVR在预测并发症方面的临床实用性.
主要方法:
- 进行了文献审查,以评估当前PVR测量限制和替代指标.
- 一次专家共识会议 (ICI-RS 2023智库) 专注于确定最佳PVR和CISC替代指导措施.
- 分析现有证据,将PVR与尿路感染和功能衰竭等并发症联系起来.
主要成果:
- 在特定的"高"或"显著"PVR门上没有共识.
- 缺乏对术语的标准化和对不同人群中正常PVR范围的研究.
- 证据将高PVR与尿路感染和功能衰竭联系在一起是不确定的;PVR测量可能会有变化.
结论:
- 支持PVR作为尿路感染或功能衰竭并发症的预测因素的高质量证据是不够的.
- 不同种群中正常或高PVR的最终值仍未确定.
- 泌尿动力学发现和其他参数可能提供更好的并发症预测,为指导CISC管理提供进一步研究的理由.
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